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Low rate of bacteremia in children hospitalized with pneumonia
Clinical Question
What is the prevalence of bacteremia in children hospitalized with community-acquired pneumonia?
Bottom line
Approximately one third of this cohort of 7509 children hospitalized with community-acquired pneumonia (and no comorbidities) had a blood culture performed, of which only 2.5% grew a pathogen. The majority of those pathogens were identified as Streptococcus pneumoniae and were susceptible to penicillin. Among the 2568 blood cultures, only 11 (0.43%) grew a pathogen that was not susceptible to penicillin. 2b
Reference
Study design: Cross-sectional
Funding: Government
Setting: Inpatient (ward only)
Synopsis
Using a health administrative database from 6 US tertiary children's hospitals, these investigators evaluated the prevalence of bacteremia in 7509 children aged 3 months to 18 years who were hospitalized with community-acquired pneumonia. (Children transferred from other hospitals and those with complex chronic conditions were excluded.) Of this cohort, 34% had a blood culture performed on day 1 or day 2 of the hospitalization. Overall, 2.5% of the blood cultures grew pathogens and 1% contained contaminants. Of the pathogens, 78% were identified as S. pneumoniae. Susceptibility to penicillin was tested on 61 of the 65 pathogens detected: 50 (82%) were susceptible, and the remaining 11 nonsusceptible pathogens represented 0.4% of the children from whom a blood culture was obtained. The rate of bacteremia in the subgroup of patients with severe or complicated pneumonia (ie, those who were admitted to the intensive care unit or required pleural drainage in the first or second day of hospitalization) was twice that of those without these factors present (4.2% vs 2.2%).
Reviewer
Nita Shrikant Kulkarni, MD
Assistant Professor in Hospital Medicine
Northwestern University
Chicago, IL
Comments
Dans le contexte d’une hospitalisation d’un enfant avec pneumonie l’utilité de la culture de sang ne semble questionable vu que la majorité semble donner d’un streptocoque mais dans le contexte d’une pneumonie aggravée la culture de sang serait plus utile.
Good poem
Do not care for this cohort of patients.
So do you do a blood culture with that frequency of positive non-susceptible cultures for effectiveness purposes? Or do you not do a blood culture for efficiency reasons?
Reassuring when prescribing amox for outpatient peds pneumonia