Abstract
Background and objectives: The objective of this study was to investigate the clinical significance of isolates from blood stream infection known to be blood culture contaminants in pediatric patients. Materials and Methods: Microbiological reports and medical records of all blood culture tests issued from 2002 to 2012 (n = 76,331) were retrospectively reviewed. Evaluation for potential contaminants were done by reviewing medical records of patients with the following isolates: coagulase-negative Staphylococcus, viridans group Streptococcus, Bacillus, Corynebacterium, Micrococcus, Aerococcus, and Proprionibacterium species. Repeated cultures with same isolates were considered as a single case. Cases were evaluated for their status as a pathogen. Results: Coagulase-negative Staphylococcus had clinical significance in 23.8% of all cases. Its rate of being a true pathogen was particularly high in patients with malignancy (43.7%). Viridans group Streptococcus showed clinical significance in 46.2% of all cases. Its rate of being a true pathogen was similar regardless of the underlying morbidity of the patient. The rate of being a true pathogens for remaining isolates was 27.7% for Bacillus and 19.0% for Corynebacterium species. Conclusions: Coagulase-negative Staphylococcus and viridans group Streptococcus isolates showed high probability of being true pathogens in the pediatric population, especially in patients with underlying malignancy.
Highlights
Blood culture as the standard in diagnosing bacteremia is a frequently issued test in pediatric patients with suspected infection
After assessment regarding subject’s clinical information was done, 25.9% of isolates included in these criteria were concluded to be true pathogens, with viridans group
Bacillus species were frequently found to be the cause of bacteremia and 27.7% of all cases that yielded Bacillus species isolates had clinical significance, with the majority of them being identified as Bacillus cereus (11 cases, 73.3% of all clinically significant Bacillus species isolates)
Summary
Blood culture as the standard in diagnosing bacteremia is a frequently issued test in pediatric patients with suspected infection. Clinical Laboratory and Standards Institute guidelines suggest that coagulase negative Staphylococcus, viridans group Streptococcus, Bacillus, Corynebacterium, Micrococcus, Aerococcus, and Proprionibacterium species can be used as evidence of contaminants in blood culture results [1]. Children with potential immunocompromised status are known to have blood stream infection from coagulase negative Staphylococcus [2,3,4]. The objective of this study was to investigate the clinical significance of isolates from blood stream infection known to be blood culture contaminants in pediatric patients. Evaluation for potential contaminants were done by reviewing medical records of patients with the following isolates: coagulase-negative Staphylococcus, viridans group Streptococcus, Bacillus, Corynebacterium, Micrococcus, Aerococcus, and Proprionibacterium species. The rate of being a true pathogens for remaining isolates was 27.7% for Bacillus and 19.0% for Corynebacterium species.
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