Blood Culture in Evaluation of Pediatric Community-Acquired Pneumonia: A Systematic Review and Meta-analysis

Tam, Pui Ying Iroh; Bernstein, Ethan; Ma, Xiaoxiao; Ferrieri, Patricia

doi:10.1542/hpeds.2014-0138

Cited by 62 publications

(36 citation statements)

References 55 publications

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“…Although culture of bacteria from normally sterile sites remains the “gold standard” for confirming bacterial infection, culture results may take several days and are frequently negative when infection resides in inaccessible sites or when antibiotics have been previously administered 1–3. Current practice is to admit ill-appearing febrile children to hospital and administer parenteral antibiotics while awaiting culture results 4–6.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Test Accuracy of a 2-Transcript Host RNA Signature for Discriminating Bacterial vs Viral Infection in Febrile Children

Herberg

Kaforou

Wright

et al. 2016

JAMA

273

326

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Section: Introductionmentioning

confidence: 99%

Diagnostic Test Accuracy of a 2-Transcript Host RNA Signature for Discriminating Bacterial vs Viral Infection in Febrile Children

Herberg

Kaforou

Wright

et al. 2016

JAMA

273

326

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“…The WHO definition of pneumonia, based on an increase in respiratory rate, is not pathogen-specific, and diagnosing all-cause pneumonia in resource-limited settings is primarily based on crude clinical data, which makes interpretation of studies 15 with clinical all-cause pneumonia as an outcome problematic and poorly concordant with true pneumococcal disease. 76 In addition, studies that focus on bacteremic pneumonia represent only a fraction (4.2–9.9%) 77,78 of all pneumococcal community-acquired pneumonia in children. Our results for nonbacteremic pneumonia reveal an incidence that is 3–12-fold higher than bacteremic pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

Tam

Thielen

Obaro

et al. 2017

Vaccine

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Background Determining the incidence, disease-associated serotypes and antimicrobial susceptibility of invasive pneumococcal disease (IPD) among children in Africa is essential in order to monitor the impact of these infections prior to widespread introduction of the pneumococcal conjugate vaccine (PCV). Methods To provide updated estimates of the incidence, serotype distribution, and antimicrobial susceptibility profile of Streptococcus pneumoniae causing disease in Africa, we performed a systematic review of articles published from 2000–2015 using Ovid Medline and Embase. We included prospective and surveillance studies that applied predefined diagnostic criteria. Meta-analysis for all pooled analyses was based on random-effects models. Results We included 38 studies consisting of 386,880 participants in 21 countries over a total of 350,613 person-years. The pooled incidence of IPD was 62.6 (95% CI 16.9, 226.5) per 100,000 person-years, including meningitis which had a pooled incidence of 24.7 (95% CI 11.9, 51.6) per 100,000 person-years. The pooled prevalence of penicillin susceptibility was 78.1% (95% CI 61.9, 89.2). Cumulatively, PCV10 and PCV13 included 66.9% (95% CI 55.9, 76.7) and 80.6% (95% CI 66.3, 90.5) of IPD serotypes, respectively. Conclusions Our study provides an integrated and robust summary of incidence data, serotype distribution and antimicrobial susceptibility for S. pneumoniae in children ≤5 years of age in Africa prior to widespread introduction of PCV on the continent. The heterogeneity of studies and wide range of incidence rates across the continent indicate that surveillance efforts should be intensified in all regions of Africa to improve the integrity of epidemiologic data, vaccine impact and cost benefit. Although the incidence of IPD in young children in Africa is substantial, currently available conjugate vaccines are estimated to cover the majority of invasive disease-causing pneumococcal serotypes. These data provide a reliable baseline from which to monitor the impact of the broad introduction of PCV.

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“…Streptococcus pneumoniae is the most commonly isolated organism, followed by Haemophilus influenza and Staphylococcus aureus . When Strep.…”

Section: Discussionmentioning

confidence: 99%

“…analysed paediatric patients with pneumonia in the United States, and found a positive blood culture rate of 2.7% with no changes in management made on the basis of the blood cultures in any of the 409 patients with positive blood culture results. A systematic review by Iroh et al . showed conflicting results in the studies looking at the effect of positive blood cultures in antibiotic management.…”

Section: Discussionmentioning

confidence: 99%

Utility of blood cultures in children admitted to hospital with community‐acquired pneumonia

Davis

Evans

Murtas

et al. 2016

J Paediatrics Child Health

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Blood Culture in Evaluation of Pediatric Community-Acquired Pneumonia: A Systematic Review and Meta-analysis

Abstract: KEY WORDS

Cited by 62 publications

References 55 publications

Diagnostic Test Accuracy of a 2-Transcript Host RNA Signature for Discriminating Bacterial vs Viral Infection in Febrile Children

Diagnostic Test Accuracy of a 2-Transcript Host RNA Signature for Discriminating Bacterial vs Viral Infection in Febrile Children

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

Utility of blood cultures in children admitted to hospital with community‐acquired pneumonia

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