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Detection and quantitation of bacteremia in childhood
Insights
Directly plating blood cultures offers faster identification of bacterial infections in children with fever. This method detected more cases than routine cultures, aiding in risk assessment for severe complications like meningitis.
Area of Science:
- Pediatrics
- Microbiology
- Infectious Diseases
Background:
- Fever in children often necessitates blood cultures to identify bacterial infections.
- Routine blood cultures can have limitations in speed and detection sensitivity.
Purpose of the Study:
- To evaluate a direct plating technique for quantitative blood cultures in febrile children.
- To compare the efficacy of direct plating with routine broth cultures.
Main Methods:
- Direct plating of 10 and 100 microliters of blood onto solidified media was performed.
- 383 children with fever underwent both direct plating and routine blood cultures.
- Positive cultures were identified and bacterial counts quantified.
Main Results:
- 14 positive cultures from 12 patients were identified, including Hemophilus influenzae type b, Streptococcus pneumoniae, and Staphylococcus aureus.
- The direct-plating technique provided more rapid identification and detected three additional positive episodes.
- Higher bacterial counts (>10(3) bacteria/ml) were associated with meningitis, particularly in Hemophilus influenzae type b cases.
Conclusions:
- Direct plating of blood cultures enhances the rapid detection of bacteremia in children.
- This quantitative method can help identify children at higher risk for severe septic complications.
- The technique shows promise for improved diagnosis and risk stratification in pediatric infections.
Abstract:
Quantitative blood cultures were sought in 383 children, from whom routine blood cultures were obtained because of fever, by direct plating of 10 and 100 microliter blood onto solidified media. There were 14 positive cultures from 12 patients. These were 7 Hemophilus influenzae type b, 5 Streptococcus penumoniae, and 2 Staphylococcus aureus. The direct-plating technique permitted more rapid identification of positive cultures, and detected three episodes not identified by routine broth culture. Bacterial counts ranged from 20 to greater than 10(4) bacteria/ml blood. In the three cases of H. influenzae type b meningitis, bacteremia exceeded 10(3)/ml. Among nine patients in whom bacteremia was unassociated with meningitis, (bacteremia without evident localized disease 5, pneumonia 2, epiglottitis 1, peritonitis 1), bacteremia was less than 10(3)/ml. This technique may aid detection of bacteremia and help identify those children at highest risk for developing septic complications, such as meningitis.