Blood culture contaminants in a paediatric population

Retrospective study from a tertiary hospital in Oman

Mohamed A. El-Naggari, Sharef W. Al-Mulaabed, Zakaria Al-Muharrmi, Renjith Mani, Rana Abdelrahim, Reem Abdwani

Research output: Contribution to journalArticle

Abstract

Objectives: Most children presenting with febrile illness require a blood culture to determine the causative organism as well as its sensitivity to antibiotics. However, false-positive results lead to unnecessary hospitalisations, prescriptions and tests. This study aimed to evaluate the impact of false-positive blood cultures among a paediatric population at a tertiary hospital in Oman. Methods: This retrospective study included all 225 children <13 years old with positive blood cultures who presented to the Sultan Qaboos University Hospital, Muscat, Oman, between July 2011 and December 2013. Blood cultures were reviewed to determine whether they were true-positive or contaminated. Results: A total of 344 positive blood cultures were recorded during the study period, of which 185 (53.8%) were true-positive and 159 (46.2%) were contaminated. Most true-positive isolates (26.5%) were coagulase-negative Staphylococcus spp. (CONS) followed by Escherichia coli (9.7%), while the majority of contaminated isolates were CONS (67.9%) followed by Streptococcus spp. (6.9%). Children with contaminated cultures were significantly younger (P <0.001) while those with true-positive cultures required significantly more frequent hospital admissions, longer hospital stays and more frequent antibiotic prescriptions (P <0.001 each). Chronic illness and mortality was significantly more frequent among those with true-positive cultures (P <0.001 and 0.04, respectively). While white blood cell and absolute neutrophil counts were significantly higher in truepositive cultures (P <0.001 each), there was no significant difference in C-reactive protein (CRP) level (P = 0.791). Conclusion: In this population, CRP level was not an adequate marker to differentiate between true- and falsepositive cultures. A dedicated well-trained phlebotomy team for paediatric patients is essential.

Original languageEnglish
Pages (from-to)e202-e208
JournalSultan Qaboos University Medical Journal
Volume17
Issue number2
DOIs
Publication statusPublished - May 1 2017

Fingerprint

Oman
Tertiary Care Centers
Retrospective Studies
Pediatrics
Population
C-Reactive Protein
Prescriptions
Anti-Bacterial Agents
Phlebotomy
Coagulase
Streptococcus
Staphylococcus
Length of Stay
Hospitalization
Neutrophils
Leukocytes
Chronic Disease
Fever
Blood Culture
Escherichia coli

Keywords

  • Blood Cultures
  • C-Reactive Protein
  • False Positive Reactions
  • Fever
  • Length of Stay
  • Oman
  • Pediatrics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Blood culture contaminants in a paediatric population : Retrospective study from a tertiary hospital in Oman. / El-Naggari, Mohamed A.; Al-Mulaabed, Sharef W.; Al-Muharrmi, Zakaria; Mani, Renjith; Abdelrahim, Rana; Abdwani, Reem.

In: Sultan Qaboos University Medical Journal, Vol. 17, No. 2, 01.05.2017, p. e202-e208.

Research output: Contribution to journalArticle

El-Naggari, Mohamed A. ; Al-Mulaabed, Sharef W. ; Al-Muharrmi, Zakaria ; Mani, Renjith ; Abdelrahim, Rana ; Abdwani, Reem. / Blood culture contaminants in a paediatric population : Retrospective study from a tertiary hospital in Oman. In: Sultan Qaboos University Medical Journal. 2017 ; Vol. 17, No. 2. pp. e202-e208.
@article{b2f2b41fb9944d83a3c78c3513af41e9,
title = "Blood culture contaminants in a paediatric population: Retrospective study from a tertiary hospital in Oman",
abstract = "Objectives: Most children presenting with febrile illness require a blood culture to determine the causative organism as well as its sensitivity to antibiotics. However, false-positive results lead to unnecessary hospitalisations, prescriptions and tests. This study aimed to evaluate the impact of false-positive blood cultures among a paediatric population at a tertiary hospital in Oman. Methods: This retrospective study included all 225 children <13 years old with positive blood cultures who presented to the Sultan Qaboos University Hospital, Muscat, Oman, between July 2011 and December 2013. Blood cultures were reviewed to determine whether they were true-positive or contaminated. Results: A total of 344 positive blood cultures were recorded during the study period, of which 185 (53.8{\%}) were true-positive and 159 (46.2{\%}) were contaminated. Most true-positive isolates (26.5{\%}) were coagulase-negative Staphylococcus spp. (CONS) followed by Escherichia coli (9.7{\%}), while the majority of contaminated isolates were CONS (67.9{\%}) followed by Streptococcus spp. (6.9{\%}). Children with contaminated cultures were significantly younger (P <0.001) while those with true-positive cultures required significantly more frequent hospital admissions, longer hospital stays and more frequent antibiotic prescriptions (P <0.001 each). Chronic illness and mortality was significantly more frequent among those with true-positive cultures (P <0.001 and 0.04, respectively). While white blood cell and absolute neutrophil counts were significantly higher in truepositive cultures (P <0.001 each), there was no significant difference in C-reactive protein (CRP) level (P = 0.791). Conclusion: In this population, CRP level was not an adequate marker to differentiate between true- and falsepositive cultures. A dedicated well-trained phlebotomy team for paediatric patients is essential.",
keywords = "Blood Cultures, C-Reactive Protein, False Positive Reactions, Fever, Length of Stay, Oman, Pediatrics",
author = "El-Naggari, {Mohamed A.} and Al-Mulaabed, {Sharef W.} and Zakaria Al-Muharrmi and Renjith Mani and Rana Abdelrahim and Reem Abdwani",
year = "2017",
month = "5",
day = "1",
doi = "10.18295/squmj.2016.17.02.011",
language = "English",
volume = "17",
pages = "e202--e208",
journal = "Sultan Qaboos University Medical Journal",
issn = "2075-051X",
publisher = "Sultan Qaboos University",
number = "2",

}

TY - JOUR

T1 - Blood culture contaminants in a paediatric population

T2 - Retrospective study from a tertiary hospital in Oman

AU - El-Naggari, Mohamed A.

AU - Al-Mulaabed, Sharef W.

AU - Al-Muharrmi, Zakaria

AU - Mani, Renjith

AU - Abdelrahim, Rana

AU - Abdwani, Reem

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Objectives: Most children presenting with febrile illness require a blood culture to determine the causative organism as well as its sensitivity to antibiotics. However, false-positive results lead to unnecessary hospitalisations, prescriptions and tests. This study aimed to evaluate the impact of false-positive blood cultures among a paediatric population at a tertiary hospital in Oman. Methods: This retrospective study included all 225 children <13 years old with positive blood cultures who presented to the Sultan Qaboos University Hospital, Muscat, Oman, between July 2011 and December 2013. Blood cultures were reviewed to determine whether they were true-positive or contaminated. Results: A total of 344 positive blood cultures were recorded during the study period, of which 185 (53.8%) were true-positive and 159 (46.2%) were contaminated. Most true-positive isolates (26.5%) were coagulase-negative Staphylococcus spp. (CONS) followed by Escherichia coli (9.7%), while the majority of contaminated isolates were CONS (67.9%) followed by Streptococcus spp. (6.9%). Children with contaminated cultures were significantly younger (P <0.001) while those with true-positive cultures required significantly more frequent hospital admissions, longer hospital stays and more frequent antibiotic prescriptions (P <0.001 each). Chronic illness and mortality was significantly more frequent among those with true-positive cultures (P <0.001 and 0.04, respectively). While white blood cell and absolute neutrophil counts were significantly higher in truepositive cultures (P <0.001 each), there was no significant difference in C-reactive protein (CRP) level (P = 0.791). Conclusion: In this population, CRP level was not an adequate marker to differentiate between true- and falsepositive cultures. A dedicated well-trained phlebotomy team for paediatric patients is essential.

AB - Objectives: Most children presenting with febrile illness require a blood culture to determine the causative organism as well as its sensitivity to antibiotics. However, false-positive results lead to unnecessary hospitalisations, prescriptions and tests. This study aimed to evaluate the impact of false-positive blood cultures among a paediatric population at a tertiary hospital in Oman. Methods: This retrospective study included all 225 children <13 years old with positive blood cultures who presented to the Sultan Qaboos University Hospital, Muscat, Oman, between July 2011 and December 2013. Blood cultures were reviewed to determine whether they were true-positive or contaminated. Results: A total of 344 positive blood cultures were recorded during the study period, of which 185 (53.8%) were true-positive and 159 (46.2%) were contaminated. Most true-positive isolates (26.5%) were coagulase-negative Staphylococcus spp. (CONS) followed by Escherichia coli (9.7%), while the majority of contaminated isolates were CONS (67.9%) followed by Streptococcus spp. (6.9%). Children with contaminated cultures were significantly younger (P <0.001) while those with true-positive cultures required significantly more frequent hospital admissions, longer hospital stays and more frequent antibiotic prescriptions (P <0.001 each). Chronic illness and mortality was significantly more frequent among those with true-positive cultures (P <0.001 and 0.04, respectively). While white blood cell and absolute neutrophil counts were significantly higher in truepositive cultures (P <0.001 each), there was no significant difference in C-reactive protein (CRP) level (P = 0.791). Conclusion: In this population, CRP level was not an adequate marker to differentiate between true- and falsepositive cultures. A dedicated well-trained phlebotomy team for paediatric patients is essential.

KW - Blood Cultures

KW - C-Reactive Protein

KW - False Positive Reactions

KW - Fever

KW - Length of Stay

KW - Oman

KW - Pediatrics

UR - http://www.scopus.com/inward/record.url?scp=85026451109&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026451109&partnerID=8YFLogxK

U2 - 10.18295/squmj.2016.17.02.011

DO - 10.18295/squmj.2016.17.02.011

M3 - Article

VL - 17

SP - e202-e208

JO - Sultan Qaboos University Medical Journal

JF - Sultan Qaboos University Medical Journal

SN - 2075-051X

IS - 2

ER -