TY - JOUR
T1 - How many sources should be cultured for the diagnosis of a blood stream infection in children with cancer?
AU - Doganis, Dimitrios
AU - Asmar, Basim
AU - Yankelevich, Maxim
AU - Thomas, Ronald
AU - Ravindranath, Yaddanapudi
N1 - Funding Information:
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This work was supported by the Georgie Ginopolis Fund.
PY - 2013/8
Y1 - 2013/8
N2 - Blood stream infection (BSI) in a child with cancer is a life-threatening condition while blood cultures (BCs) play a crucial role for the diagnosis. The current practice of obtaining a BC from all sources-peripheral vein, central venous catheter (CVC), all lumens-is controversial and therefore in this study, our aim was to evaluate the utility of obtaining BCs from all these available sources. A retrospective study of BC sets obtained from all newly diagnosed patients with malignancy was conducted. A total number of 633 BC sets from 123 boys and 88 girls (median age: 5 5/12 years) were evaluated during infection episodes from January 1, 2005, to August 31, 2010. Among these cases, 134 were classified as true BSI (21%), 468 as non-BSI, and 31 as false-positive. In 64 cases, the results from peripheral and CVC sources were discordant: 57 catheter positive-peripheral negative and seven catheter negative-peripheral positive. Consequently, seven out of 134 true BSIs (5.2%) would not have been identified if only a BC from a CVC had been obtained. Moreover, if no BCs from all lumens had been obtained we would have missed up to 25% of true-positive BSIs. In the same way, if BCs from all sources had not been drawn we would not have detected up to 52% of true-positive BSIs. Conclusion: Obtaining BCs during an infection episode from all sources in a child with cancer is still mandatory.
AB - Blood stream infection (BSI) in a child with cancer is a life-threatening condition while blood cultures (BCs) play a crucial role for the diagnosis. The current practice of obtaining a BC from all sources-peripheral vein, central venous catheter (CVC), all lumens-is controversial and therefore in this study, our aim was to evaluate the utility of obtaining BCs from all these available sources. A retrospective study of BC sets obtained from all newly diagnosed patients with malignancy was conducted. A total number of 633 BC sets from 123 boys and 88 girls (median age: 5 5/12 years) were evaluated during infection episodes from January 1, 2005, to August 31, 2010. Among these cases, 134 were classified as true BSI (21%), 468 as non-BSI, and 31 as false-positive. In 64 cases, the results from peripheral and CVC sources were discordant: 57 catheter positive-peripheral negative and seven catheter negative-peripheral positive. Consequently, seven out of 134 true BSIs (5.2%) would not have been identified if only a BC from a CVC had been obtained. Moreover, if no BCs from all lumens had been obtained we would have missed up to 25% of true-positive BSIs. In the same way, if BCs from all sources had not been drawn we would not have detected up to 52% of true-positive BSIs. Conclusion: Obtaining BCs during an infection episode from all sources in a child with cancer is still mandatory.
KW - Blood cultures
KW - Blood stream infection
KW - Cancer
KW - Catheter
KW - Children
KW - Sources
UR - http://www.scopus.com/inward/record.url?scp=84880372979&partnerID=8YFLogxK
U2 - 10.3109/08880018.2013.783892
DO - 10.3109/08880018.2013.783892
M3 - Article
C2 - 23570564
AN - SCOPUS:84880372979
VL - 30
SP - 416
EP - 424
JO - Pediatric Hematology and Oncology
JF - Pediatric Hematology and Oncology
SN - 0888-0018
IS - 5
ER -