Yield of Anaerobic Blood Cultures in Pediatric Emergency Department Patients
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Updated: Feb 23, 2026
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Published on: October 15, 2014
Itai Gross1, Oren Gordon1, Wiessam Abu Ahmad1
1From the Department of Pediatrics, School of Public Health and Community Medicine, Hadassah and The Hebrew University Medical Center, Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hadassah and The Hebrew University Medical Center, Department of Neonatology, and Department of Pediatric Emergency Medicine, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel.
Insights
Anaerobic bacteremia is rare in children, but using anaerobic blood cultures in pediatric emergency departments can increase the detection of infections. This study re-evaluated the utility of these cultures in identifying rare cases.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Bacteriology
Background:
- Current recommendations discourage routine anaerobic cultures in children due to perceived rarity of anaerobic bacteremia.
- Recent data on the incidence and diagnostic utility of anaerobic blood cultures in pediatric populations are limited.
- Pediatric emergency department (PED) policy maintained the use of both aerobic and anaerobic blood cultures, enabling this study.
Purpose of the Study:
- To re-evaluate the incidence and yield of anaerobic blood cultures in a pediatric emergency department setting.
- To assess the characteristics and risk factors associated with anaerobic bacteremia in children.
- To determine the contribution of anaerobic cultures to the overall detection of bacteremia.
Main Methods:
- A retrospective analysis of blood cultures from a tertiary care center's PED between 2002 and 2016.
- Assessment of the incidence and clinical significance of positive anaerobic blood cultures.
- Identification of risk factors for anaerobic bacteremia in pediatric patients.
Main Results:
- Out of 68,304 blood culture sets, 971 (1.42%) were clinically significant positive cultures.
- Pathogenic anaerobic bacteria were isolated in 33 (0.05%) cultures.
- Head and neck abscess and intra-abdominal infections were primary risk factors for anaerobic bacteremia.
- Anaerobic cultures uniquely identified 187 (22%) true positive cases that would have been missed otherwise.
Conclusions:
- True anaerobic bacteremia is infrequent in children presenting to the PED.
- Despite its rarity, the inclusion of anaerobic cultures can enhance the overall diagnostic yield of blood cultures in pediatric patients.
Background:
Anaerobic bacteremia is rare in children and current recommendations advocate against the routine use of anaerobic cultures in children. However, the incidence of anaerobic bacteremia and the utility of anaerobic blood cultures in children have not been assessed in recent years. Our pediatric emergency department (PED) policy still supports the use of both aerobic and anaerobic blood cultures in all cases of suspected bacteremia. This allowed us to re-evaluate the yield of anaerobic cultures in PED settings.
Methods:
Retrospective data of all blood cultures taken in the PED in a single tertiary center from 2002 to 2016 were collected. The incidence and characteristics of children with positive anaerobic blood cultures were assessed. Risk factors for anaerobic bacteremia were defined.
Results:
Of the 68,304 blood culture sets taken during the study period, 971 (1.42%) clinically significant positive cultures were found. Pathogenic obligatory anaerobic bacteria were isolated in 33 (0.05%) cultures. The leading risk factors for anaerobic bacteremia were head and neck abscess and intra-abdominal infection. Of all the true positive cultures, 187 (22%) were only detected in the anaerobic culture and would have otherwise been missed.
Conclusions:
True anaerobic bacteremia is extremely rare in children admitted to the PED. Nevertheless, using anaerobic cultures may increase the overall yield of blood cultures.
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