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Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
Published on: October 15, 2014
Culture-proven Bloodstream Infections at a Specialist Pediatric Hospital
Laila S Al Yazidi1,2, Alexander C Outhred1,2,3, Philip N Britton1
1From the Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, Australia.
Insights
Bloodstream infections (BSI) in children are a significant cause of illness and death. Most BSIs in this study were healthcare-associated or hospital-onset, emphasizing infection control importance.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Bloodstream infection (BSI) is a major cause of childhood morbidity and mortality.
- Understanding local epidemiology and outcomes of pediatric BSIs is crucial for effective management.
- This study focused on community-onset BSI within a large pediatric hospital setting.
Purpose of the Study:
- To assess the local epidemiology of bloodstream infections (BSIs) in children.
- To evaluate the outcomes of BSIs managed at a specialist pediatric hospital.
- To specifically analyze community-onset BSIs in the pediatric population.
Main Methods:
- Retrospective review of laboratory-confirmed BSIs in children aged 0-18 years.
- Data collected over a 3-year period (2014-2016) at The Children's Hospital at Westmead.
- Analysis included BSI rates, contamination rates, demographics, isolate profiles, antimicrobial resistance, and mortality.
Main Results:
- Out of 47,368 blood cultures, 991 (2.1%) yielded clinically significant isolates, with 465 BSI episodes in 391 children.
- Community-onset healthcare-associated (HCA) and hospital-onset BSIs constituted the majority (71.8%).
- Staphylococcus aureus and Escherichia coli were the most common pathogens; 30-day mortality was 3.3%, primarily in children with comorbidities.
Conclusions:
- The majority of pediatric bloodstream infections were community-onset healthcare-associated or hospital-onset.
- This underscores the critical need for robust infection control and central venous catheter care.
- Staphylococcus aureus associated with osteoarticular infections was predominant among community-associated BSIs.
Background:
Bloodstream infection (BSI) is one of the leading causes of morbidity and mortality in children. This study was done to assess the local epidemiology and outcome of BSIs managed at a large specialist pediatric hospital with a focus on community-onset BSI.
Methods:
We retrospectively reviewed laboratory-confirmed BSI in children (0-18 years) at The Children's Hospital at Westmead over a 3-year period (2014-2016). Laboratory data and patient medical records were used to determine BSI rates, blood culture contamination rates, patient demographics, isolate profile, antimicrobial resistance and mortality rate in this cohort.
Results:
In total, 47,368 blood cultures were collected; 1027 (2.2%) grew probable contaminants and 991 (2.1%) grew clinically significant isolates. Clinically significant bacteremia accounted for 4.8 per 1000 admissions, with 391 children managed for 465 culture-proven BSI episodes. One hundred thirty-one (28.2%) episodes were community-onset community-associated, and 334 (71.8%) were either community-onset healthcare-associated (HCA) (187; 40.2 %) or hospital-onset (147; 31.6%). Of the significant isolates, 243 (52.3%) were Gram-positive bacteria, 198 (42.6%) were Gram-negative bacteria, 6 (1.3%) were polymicrobial infections and 18 (3.9%) were yeast. Staphylococcus aureus (115; 24.7%) and Escherichia coli (54; 11.6%) were the most common organisms identified. Osteoarticular infection (44; 33.6%) and urosepsis (23; 17.6%) were the most frequent sites of infection associated with non-HCA BSI. Mortality at 30 days was reported in 15 (3.3%) children, all whom had preexisting comorbidities.
Conclusions:
The majority of BSI episodes managed in our hospital were either community-onset HCA or hospital-onset infections. This highlights the considerable importance of infection control and central venous catheter device care initiatives. Among community-associated BSI, S. aureus in association with osteoarticular infection was predominant.
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