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Positive blood cultures in a pediatric emergency department: a descriptive analysis

Rodríguez Fanjul J, Hernández Bou S, Trenchs Sainz De La Maza V, Luaces Cubells C

Servicio de Urgencias, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain.

We describe the infections and microorganisms causing bacteremia in an emergency
department and to analyze the influence of a positive blood culture on subsequent
management. It is a retrospective study of positive blood cultures ordered in the
emergency department in 2008 and 2009. A change in therapeutic approach was
defined as the initiation or modification of antibiotic therapy and/or hospital admission.
A total of 7582 blood cultures were ordered. Bacteria grew in 382 (5.0%); 88 (23.0%)
were true positives. Pneumonia and urinary tract infection were the main diagnoses
associated with bacteremia. The pathogens implicated most often were Streptococcus
pneumoniae and Escherichia coli. A positive blood culture led to a change in therapeutic
approach in a third of the cases, mainly in patients with fever of unknown origin. We
conclude that the management changed on the basis of blood culture findings in a
significant number of cases although given the low prevalence of bacteremia, the overall
impact was low.

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