scholarly journals Things We Do For No Reason™: Routine Blood Culture Acquisition for Children Hospitalized with Community-Acquired Pneumonia

2019 ◽  
pp. 107-110
Author(s):  
David P Johnson ◽  
Vivian Lee ◽  
Anand Gourishankar ◽  
Prabi Rajbhandari ◽  
Matthew Schefft ◽  
...  
2019 ◽  
Vol 08 (03) ◽  
pp. 144-147
Author(s):  
Christine Anh-Thu Tran ◽  
Jenna Verena Zschaebitz ◽  
Michael Campbell Spaeder

AbstractBlood culture acquisition is integral in the assessment of patients with sepsis, though there exists a lack of clarity relating to clinical states that warrant acquisition. We investigated the clinical status of critically ill children in the timeframe proximate to acquisition of blood cultures. The associated rates of systemic inflammatory response syndrome (72%) and sepsis (57%) with blood culture acquisition were relatively low suggesting a potential overutilization of blood cultures. Efforts are needed to improve decision making at the time that acquisition of blood cultures is under consideration and promote percutaneous blood draws over indwelling lines.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S739-S739
Author(s):  
Jessica Snawerdt ◽  
Derek N Bremmer ◽  
Dustin R Carr ◽  
Thomas L Walsh ◽  
Tamara Trienski ◽  
...  

Abstract Background The 2019 community-acquired pneumonia (CAP) guidelines recommend obtaining a sputum culture in patients who are empirically treated for methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa to assist clinicians in optimizing antimicrobial therapy. A previous study at our institution found respiratory cultures were rarely obtained in patients with CAP. As a result of these findings, an educational campaign was implemented to promote the use of an induced sputum protocol. Methods This was a multicenter, retrospective cohort study that included patients who were ≥18 years of age, had a diagnosis of CAP, and received ≥48 hours of anti-pseudomonal antibiotics. Patients were excluded if mechanically ventilated within 48 hours of admission or diagnosed with hospital-acquired or ventilator-associated pneumonia. Patients were grouped into pre- and post-intervention time periods. The intervention involved education on obtaining respiratory cultures including technique on induced sputums and updates to CAP order sets. The primary outcome was the rate of sputum culture acquisition. Secondary outcomes included duration of anti-pseudomonal and anti-MRSA therapy, in-hospital mortality, and length of stay. Results A total of 143 patients met inclusion criteria, 72 in the pre-implementation group and 71 in the post-implementation group. Baseline characteristics were similar between the two groups. More patients in the post-implementation group had a sputum culture obtained but the difference was not statistically significant (38.9% vs 53.5%; p=0.08). Anti-pseudomonal therapy was continued for an average of 5.6 days pre-implementation and 5.2 days post-implementation (p=0.499). There was also not a significant difference in anti-MRSA duration between the two groups (3.4 days vs 3.2 days; p=0.606). In-hospital mortality and length of stay were similar between the two groups. Conclusion An educational campaign focusing on the acquisition of induced sputums led to an increase in rates of sputum cultures collected. However, this did not correlate with a decrease in duration of anti-MRSA or anti-pseudomonal therapy. Further interventions should be made to optimize de-escalation of broad spectrum antibiotics based on sputum culture results. Disclosures All Authors: No reported disclosures


2017 ◽  
Vol 34 (3) ◽  
pp. 128-134
Author(s):  
Md Abdus Salam ◽  
Md Robed Amin ◽  
Quazi Tarikul Islam

Introduction: Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. According to recent WHO data, each year 3-4 million patients die from pneumonia. The clinical presentations and bacterial agents responsible for community acquired pneumonia (CAP) varies according to geography and culture.Methods: A cross sectional observational study conducted among the 53 consecutive patients with a clinical diagnosis of CAP in admitted patient in the department of Medicine, DMCH, during January 2010 to December 2010. Hematological measurements (TC of WBC, Hb%, ESR, platelet count), blood culture, chest X-ray P/A view, sputum for Gram staining and culture sensitivity, sputum for AFB, blood urea and random blood sugar were done in all cases. ELISA for IgM antibody of Mycoplasma pneumoniae and Chlamydia pneumoniae were done in sputum culture negative cases.Results: The mean (±SD) age was 38.9±17.3 years and Male female ratio was 3:1. Fever, chest pain and productive cough were the most common clinical features. The mean (±SD) respiratory rate was 23.0±2.8 /minute . COPD and DM were found in 17.0% and 5.7% of patients respectively . Blood culture was found positive in only 1.9% of the study patients. Gram positive Cocci 62.26%, Gram negative Bacilli 9.43%, mixed Gram positive cocci and Gram negative bacilli 11.32% and Gram negative Cocco Bacilli 1.9% were observed and in 15.03 % cases, no bacteria could be seen. Sputum culture revealed 53.8% streptococcus pneumoniae, 26.9% Klebsiella pneumonia as predominant organism. Mycoplasma pneumoniae and Chlamydia pneumoniae were found in 7.4% and 3.7% respectively by serological test. For Streptococcus pneumoniae, sensitive antibiotics were Amoxyclav and Levofloxacin. For Gram negative bacilli and coccobacilli, more sensitive antibiotics were Meropenem, Ceftriaxone, and Clarithromycin. The best sensitive drug were found meropenem. The mean (±SD) duration of hospital stay was 5.0±1.7 days with ranging from 3 to 10 days.Conclusion: Region based bacteroiological diagnosis of Cap is important for selecting the best and sensitive drugs for complete cure.J Bangladesh Coll Phys Surg 2016; 34(3): 128-134


PEDIATRICS ◽  
2017 ◽  
Vol 140 (3) ◽  
pp. e20171013 ◽  
Author(s):  
Mark I. Neuman ◽  
Matthew Hall ◽  
Susan C. Lipsett ◽  
Adam L. Hersh ◽  
Derek J. Williams ◽  
...  

2020 ◽  
Vol 7 (12) ◽  
pp. 5144-5153
Author(s):  
Abu Kausar Mohammad ◽  
Morshed Nasir ◽  
Sujat Paul ◽  
Habibur Rahman ◽  
Kalam Abul ◽  
...  

Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. Community-acquired pneumonia (CAP) is associated with a significant mortality and morbidity. Knowledge of predominant microbial patterns in CAP constitutes the basis for initial decisions about empirical antimicrobial treatment. The aim of this study was to identify the bacterial etiology of CAP in adult hospitalized patients and to see their antibiotic sensitivity pattern. It was a hospital based cross sectional observational study on 87 hospitalized patients diagnosed with CAP admitted in Medicine department of Chittagong Medical College Hospital (CMCH). Sputum for Gram staining, Z N staining, culture sensitivity, blood culture and sensitivity and PCR for Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumonia and Streptococcus pneumonia were done. Patients were followed up for in-hospital outcome and 30-day mortality. The mean (±SD) age was 49.59±16.97 years and male female ratio was 1.56:1. Sputum culture, blood culture and PCR were positive in 60.9%, 1.1% and 4.6% of the samples respectively. Klebsiella pneumoniae was identified in the sputum culture of the majority of the patients (39.1%), followed by Pseudomonas aeruginosa (10.3%), Staphylococcus aureus and Escherichia coli (5.7%). The only one sample which was positive in blood culture and it was Staphylococcus aureus. Streptococcus pneumoniae was identified in all the 4 PCR positive cases. The highly sensitive drugs were meropenem, levofloxacin and amikacin. In hospital mortality and 30-day mortality was 6.9% and 16.1% respectively. Gram-negative bacteria pre-dominate in the bacteriologic profile of CAP using conventional sputum and blood culture. There is need for further conventional serologic tests for atypical and viral pathogens in all patients admitted with CAP.


Author(s):  
Bazlin Ramly ◽  
Animitra Das ◽  
Juliette Lucey ◽  
Navdeep Kaur Brar

2021 ◽  
Vol 6 (2) ◽  
pp. 125-129
Author(s):  
Kunachgi Preeti Nagkumar ◽  
Ch Bhadra Reddy ◽  
M Hima Bindu ◽  
Chinthaparthi Mallikarjuna Reddy

Pneumonia is defined as an infection and inflammation of the alveoli and the bronchioles. It is caused by microorganisms when the hosts’ defences are overcome by their virulence. Community Acquired Pneumonia affects people of all age groups, though the elderly is especially susceptible. This retrospective study was conducted on 56 patients above the age of 65 years who were admitted to our hospital for pneumonia. Demographic data of the patients such as age, sex, weight, temperature blood pressure etc. was taken. History of underlying disease, comorbidities, cardiopulmonary function was noted. Data on the laboratory investigations such as Complete Blood Picture, haemoglobin estimation, Blood glucose levels, Kidney function tests, liver function rests, electrolyte levels, CRP, D Dimer were noted. Details of chest X rays or Ultra sound, ABG analysis were also noted. Details of sputum culture and sensitivity and blood culture and sensitivity for the patients was also noted. the most common comorbidity was hypertension, followed by cerebrovascular diseases cardiopathy, COPD and diabetes. Klebsiella pneumoniae was isolated in 69.6%, Pseudomonas aeruginosa in 48.2%, Candida albicans in 51.8% and Acinetobacter baumanni in 44.6% cases in sputum culture and in blood culture Klebsiella pneumoniae was isolated in 16.1%) followed by Pseudomonas aeruginosa in 8.9% cases. Community acquired pneumonia contributes significantly to the health burden of the world especially causing severe morbidity and mortality among the elderly patients. For a better prognosis, it is important to diagnose and identify the risk factors so that the severity of the infection can be prevented.


Pathology ◽  
2014 ◽  
Vol 46 (7) ◽  
pp. 636-639 ◽  
Author(s):  
Michael J. Marginson ◽  
Kathryn L. Daveson ◽  
Karina J. Kennedy

2018 ◽  
Vol 42 (3) ◽  
pp. 112-117
Author(s):  
MA Mannan ◽  
Nazmun Nahar ◽  
Firoz Ahmed ◽  
Ismat Jahan ◽  
Taskina Mosleh ◽  
...  

Background: Pneumonia is one of the causes of neonatal infection and responsible for significant morbidity and mortality, especially in developing countries. The study was aimed to reveal frequency and outcome of pneumonia among hospitalized sick newborn of neonatal intensive care unit. Methodology: This observational study was carried out in the NICU of Bangabandhu Sheikh Mujib Medical University (BSMMU) on 94 neonates with the diagnosis of pneumonia admitted from July 2012 to June 2014. All studied neonates were subjected to history taking, clinical examination, routine investigations, chest radiography and blood culture and sensitivity. Results: Incidence of neonatal pneumonia was 43% among admitted neonates with respiratory distress. Mean birth weight and gestational age were 2392±854 and 33±3.9 weeks respectively. Of enrolled infants with pneumonia, 38 (40.4%) were early onset, 24 (25%) were hospital acquired pneumonia and community acquired pneumonia was documented in 14 (14.8 %) and the rest 18 (19%) were ventilator associated pneumonia. Blood culture was positive in 18 (19%) of cases with neonatal pneumonia; most common pathogen isolated was acinetobacter. Mean duration of hospital stay was 19±8 days. Most of the neonatal pneumonia were cured 72 (76%) with therapy, whereas 17 (18%) died during their hospital course. Conclusion: Overall incidence among admitted sick neonates was 8.4% which constituted 34% of distressed neonate. Bangladesh J Child Health 2018; VOL 42 (3) :112-117


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