Using anaerobic blood cultures for infants younger than 90 days rarely showed anaerobic infections but increased yields of bacterial growth

Gross, Itai; Gordon, Oren; Benenson, Shmuel; Ahmad, Wiessam Abu; Shimonov, Amir; Hashavya, Saar; Eventov‐Friedman, Smadar

doi:10.1111/apa.14262

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…The use of an anaerobic blood culture bottle is important not only for the recovery of anaerobic bacteria but also for the recovery of facultative anaerobes that grow better under anaerobic conditions. The use of an anaerobic culture bottle also reduces the time to detection of microbial growth [23,[30][31][32]. Our data confirm these findings.…”

Section: Discussionsupporting

confidence: 87%

Identification and distribution of anaerobic bacteria isolated from clinical specimens in a University Hospital: 4 years’ experience

Sancak

Mirza

Altun

et al. 2022

Microbiology Independent Research Journal (MIR Journal)

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Anaerobes, which are components of microbiota, can cause life-threatening infections. Because of their fastidious nature, they are difficult to isolate and are often overlooked. The goal of this study was to identify the anaerobic bacteria isolated from clinical specimens at the Central Laboratory of Hacettepe University Hospital in 2015-2018 and to evaluate the distribution of the isolated bacterial species among the different specimen types. The anaerobic bacteria isolated from the specimens were identified by the conventional methods and MALDI-TOF MS.Overall, 15,300 anaerobic cultures were studied. Of these, 14,434 (94.3%) were blood samples and 866 (5.7%) were other clinical specimens. A total of 138 anaerobic bacteria were isolated: 62 (44.9%) were isolated from blood samples and 76 (55.1%) from other specimens. The most isolated anaerobes from blood cultures were Bacteroides spp. (41.9%), followed by Cutibacterium acnes (25.8%) and Clostridium spp. (9.7%). The most isolated anaerobes from the other specimens were Gram-negative bacilli, including Bacteroides spp. (15.8%), Fusobacterium spp. (14.5%), Prevotella spp. (14.5%), and Porphyromonas spp. (2.6%). Anaerobic Finegoldia magna represented the major species among the isolated Gram-positive bacteria (10.5%). Anaerobic growth was observed in 0.4% of all the blood cultures and in 5.8% of the positive blood cultures. The results of our study showed that the incidence of anaerobic bacteremia was stable during the 2015-2018 period.

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Section: Discussionsupporting

confidence: 87%

Identification and distribution of anaerobic bacteria isolated from clinical specimens in a University Hospital: 4 years’ experience

Sancak

Mirza

Altun

et al. 2022

Microbiology Independent Research Journal (MIR Journal)

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“…[5] This is supported by studies showing that, despite the low prevalence of bacteremia by strict anaerobes in neonates and children (< 1%), as many as 11-22% of clinically relevant isolates were only detectable in anaerobic bottles. [19,20] This could be secondary to the anaerobic culture's more optimal conditions for growth of facultative anaerobic organisms that are prevalent in the neonatal population, like Streptococcus agalactiae. A study showed that there is additional value in the use of anaerobic bottles in very-low-birth-weight infants, where 16% of all cases of early-onset sepsis were secondary to obligate anaerobes.…”

Section: Discussionmentioning

confidence: 99%

Blood Volume Collected for Cultures in Infants with Suspected Neonatal Sepsis

Altez,

Soghier,

Campos

et al. 2024

Preprint

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Objectives To evaluate blood culture sample volumes, identify factors linked to insufficient samples, and compare volumes among neonates treated for culture-negative-sepsis, sepsis-rule-outs, and bloodstream infections (BSI).Methods Observational cohort of blood cultures collected during NICU stay. Association of age, weight, gender, source, and collection time with lower-than-recommended volumes was determined by logistic regression. Blood culture inocula of patients with culture-negative-sepsis, sepsis rule-out, and BSI were compared using ANOVA.Results 742 blood cultures were obtained from 292 neonates. Median inoculum was 1mL (IQR:0.6–1.4), and 259 bottles (35%) had inocula < 0.9mL. Night shift sample collection was associated with lower-than-recommended volumes (p = 0.006). No difference in sample volumes was observed between culture-negative-sepsis, sepsis-rule-outs, and BSI (p = 0.5).Conclusions Median NICU blood culture volumes align with recommendations. Night shift collections correlate with lower volumes. Sample volumes don’t differ in patients with culture-negative-sepsis, BSI, and sepsis-rule-out, and should not be a justification for longer duration of antibiotics.

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“…A better use for the blood required to conduct the test would be to inoculate it into culture media. The criterion standard for late-onset sepsis is blood culture, and the accuracy of blood culture is driven directly by the volume of blood obtained for culture . The challenges of obtaining sufficient volume for culture in preterm infants have been well described .…”

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confidence: 99%

C-Reactive Protein Testing in Late-Onset Neonatal Sepsis

Cantey¹,

Bultmann²

2020

JAMA Pediatr

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Imagine for a moment you are counseling a patient with a suspicious mass and symptoms that are concerning but nonspecific. Although there are several possible diagnoses, one hangs unspoken between you and the patient-a diagnosis that carries significant morbidity and mortality. You propose an immediate biopsy. After all, a tissue diagnosis is the criterion standard, and this matter is urgent. The patient agrees, and as the patient begins to stand, you raise a hand and mention another test you would like to order. The patient is curious. "What are the benefits of this test?" You explain that the test involves sending a portion of the biopsied tissue to a separate part of the laboratory, where the pathology department will look for other markers of disease. Of course, the patient nods; that makes sense. "If this extra test result is negative, I will be okay, right?" "No," you answer, "a negative test result does not mean the biopsy result will be negative." The patient frowns. "Well, is it a bad sign if the test result is positive?" "Not necessarily," you explain. "Many things can make the other test results abnormal, so we'll still have to wait on the biopsy results. The biopsy is the key." The patient sits down again, looking confused. "If the biopsy is so important, why are we wasting tissue on this other test?" "Well," you glance helplessly toward the window then look back to your frowning patient. "It's just what we've always done in these cases."This exchange is hypothetical, but in the case of Creactive protein (CRP) for neonatal sepsis, it is all too real. The nonspecific signs of late-onset infection in infants, particularly those born preterm, combined with the high risk of morbidity and mortality have underscored the need for accurate diagnosis of neonatal sepsis. 1 Culture of blood and other sterile sites is the criterion standard for neonatal sepsis. However, myriad ancillary laboratory tests have been suggested as potential biomarkers for neonatal sepsis; these include CRP, complete blood counts with differential, procalcitonin, a variety of interleukins, and presepsin. 2 The value of those tests in the clinical management of suspected sepsis is questionable. In this issue of JAMA Pediatrics, Brown et al 3 report their systematic review and meta-analysis of the sensitivity, specificity, and test accuracy of CRP for late-onset neonatal sepsis. They analyzed 22 studies including 2255 infants, the majority being 32 weeks or less gestational age or 1500 g or less birth weight. The median specificity of CRP was 0.74 and median sensitivity was 0.62. Assuming a cohort of 1000 preterm infants with a 20% prevalence rate of late-onset sepsis, this means that 76 cases of infection would be missed, and 208 infants would be incorrectly diagnosed as having sepsis-more than the number of infants with sepsis (200).

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Using anaerobic blood cultures for infants younger than 90 days rarely showed anaerobic infections but increased yields of bacterial growth

Cited by 6 publications

References 28 publications

Identification and distribution of anaerobic bacteria isolated from clinical specimens in a University Hospital: 4 years’ experience

Identification and distribution of anaerobic bacteria isolated from clinical specimens in a University Hospital: 4 years’ experience

Blood Volume Collected for Cultures in Infants with Suspected Neonatal Sepsis

C-Reactive Protein Testing in Late-Onset Neonatal Sepsis

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