Positive Blood Cultures in Sickle Cell Disease: Time to Positivity and Clinical Outcome

Norris, Cindy; Smith‐Whitley, Kim; McGowan, Karin L.

doi:10.1097/00043426-200305000-00008

Cited by 38 publications

(22 citation statements)

References 12 publications

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“…This is in accordance with other studies that have shown that 24-hour cultures' results are equally reliable as the 48-hour cultures [17]. Other studies have suggested that in management of febrile illness in children with SCD, the time period of observation should vary according to the severity of fever, average time to positivity of the blood culture, laboratory and social aspects [18]. In a vast majority (62%) of our patients, the cause of their febrile illness could not be identified.…”

Section: Discussionsupporting

confidence: 89%

Prevalence of Pneumococcal Bacteremia in Children with Sickle Cell Disease

Patel

Zuzo

Imran

et al. 2013

Pediatric Hematology and Oncology

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We performed a retrospective chart review of children with sickle cell disease hospitalized for fever at our local institution. We reviewed 456 hospitalizations in 133 patients between January 2006 and June 2012. The prevalence of true bacteremia was 4%. The mean C-reactive protein values and temperatures were nonsignificantly higher in patients with positive blood cultures. The mean time to detection was 22.5 hours in bacteremia compared to 32.6 hours in blood cultures that grew contaminants (p = .034). Only two (0.4%) cases of pneumococcal bacteremia were reported and both occurred before May 2010, which marks the introduction of 13-valent pneumococcal vaccine (PCV13). Both patients with pneumococcal bacteremia had discontinued penicillin prophylaxis after the age of 5 years. The first patient was immunized but contracted a nonvaccine serotype (23B). The second patient was partially vaccinated and acquired a vaccine-preventable serotype (23F). Both serotypes were sensitive to ceftriaxone and vancomycin; one was resistant to penicillin. This is the first study reporting the prevalence of pneumococcal bacteremia since the introduction of PCV13.

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Section: Discussionsupporting

confidence: 89%

Prevalence of Pneumococcal Bacteremia in Children with Sickle Cell Disease

Patel

Zuzo

Imran

et al. 2013

Pediatric Hematology and Oncology

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“…In addition, >20% of the patients included were receiving antibiotic treatment when blood was sampled, which could have altered the TTP [9]. Despite its usefulness as a prognostic tool, TTP is somewhat limited in that it has a sub-optimal sensitivity in predicting death, and because factors other than the concentration of bacteria in blood can influence its value, including the precise microorganisms cultured [26][27][28][29][30], the automated blood culture system used [26][27][28], and the presence of antimicrobial agents in the blood [31,32], all of which can make the use of a standard cut-off TTP in clinical practice difficult.…”

Section: Discussionmentioning

confidence: 99%

Time-to-positivity in patients with Escherichia coli bacteraemia

Peralta

Roiz

Sánchez

et al. 2007

Clinical Microbiology and Infection

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The time from the start of incubation to a positive reading of blood cultures (time-to-positivity; TTP) is related to the concentration of bacteria in blood. Information concerning the correlation of TTP with clinical parameters, and its usefulness as a prognostic factor in patients with Escherichia coli bacteraemia, is limited. To investigate the relationship of TTP to clinical parameters, 459 cases of monomicrobial E. coli bloodstream infections from a single institution between 1997 and 2005 were reviewed. All cases involved patients who were not undergoing antibiotic treatment at the time of blood sampling. The in-hospital mortality rate was 6.3%. Median TTP was significantly shorter for patients who died than for those who survived (9.7 h, inter-quartile range 7.85-11.05 h vs. 11.2 h, inter-quartile range 10.1-11.4 h; p <0.001). Patients with TTP in the lowest quartile were more likely to be female, to have a non-urinary tract or an unknown origin of bacteraemia, to have severe sepsis or shock, and to subsequently die. In a multivariable Cox regression model, the hazard ratio for death from any cause for patients with a short TTP was 3.13 (95% CI 1.28-7.64; p 0.01). TTP in patients with E. coli bacteraemia provides prognostic information beyond that provided by the presence of haematological illness, a Charlson score > or =3, a non-urinary tract origin of bacteraemia, and the presence of severe sepsis or shock.

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“…9 Prior to the introduction of Pneumococcal conjugate vaccines and widespread penicillin prophylaxis, S. pneumoniae was the most common pathogen isolated from children with SCD presenting with invasive bacterial disease in higher income countries. 10 In Africa, S. pneumoniae is also frequently isolated in bacteremic children with SCD, 6 but other studies have found NTS, S. aureus and Klebsiella are common, [11][12][13] perhaps indicating that splenic dysfunction is not the only cause of susceptibility to infection in SCD.…”

Section: Introductionmentioning

confidence: 99%