Neisseria meningitidis Bacteremia in Children: Quantitation of Bacteremia and Spontaneous Clinical Recovery Without Antibiotic Therapy

PEDIATRICS ◽  
1987 ◽  
Vol 80 (1) ◽  
pp. 63-67 ◽  
Author(s):  
T. Dennis Sullivan ◽  
Leonard J. LaScolea
Keyword(s):  
Blood Culture ◽  
Antibiotic Therapy ◽  
Neisseria Meningitidis ◽  
Invasive Disease ◽  
Blood Cultures ◽  
Negative Blood Culture ◽  
Clinical Recovery ◽  
Oral Amoxicillin ◽  
Occult Bacteremia ◽  
The Relationship

The relationship between the magnitude of bacteremia due to Neisseria meningitidis and the clinical diagnosis was determined for 43 children who had fever in the presence or absence of focal signs of infection. Bacteremia was quantitated by the previously described procedure using heparinized blood (0.2 to 1.0 mL). Additionally, blood was cultured by means of the radiometric Bactec technique. Seventeen patients had meningitis, 12 had meningococcemia, 13 had unsuspected or "occult" bacteremia, and five had other diagnoses. "Occult" bactermia was diagnosed initially in four patients, but subsequently meningitis was diagnosed. All 13 patients with 500 or more organisms per milliliter had meningitis or meningococcemia in contrast to 12 (55%) of 22 patients with less than 500 organisms per milliliter (P ≤ .0035). Only 18 (42%) of these patients bacteremic with N meningitidis presented with petechiae or purpura. All 13 children with occult bacteremia were sent home after blood cultures were obtained; six of the 13 received a regimen of oral amoxicillin for otitis media. At reexamination (interval 16 to 119 hours) four had meningitis, seven were clinically improved (afebrile, negative blood culture, without invasive disease), and two were still mildly febrile with negative blood culture. Three of these bacteremic children experienced spontaneous clinical and bacteriologic resolution without antibiotic treatment. This has not been previously reported.

Clinical consequences of contaminated blood cultures in adult hospitalized patients at an institution utilizing a rapid blood-culture identification system

2020 ◽  
pp. 1-7
Author(s):  
Sidra Liaquat ◽  
Lorena Baccaglini ◽  
Gleb Haynatzki ◽  
Sharon J. Medcalf ◽  
Mark E. Rupp
Keyword(s):  
Blood Culture ◽  
Antibiotic Therapy ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Blood Cultures ◽  
Hospitalized Patients ◽  
Identification System ◽  
Negative Blood Culture ◽  
Culture Identification ◽  
Contaminated Blood

Abstract Objective: To assess the clinical impact of contaminated blood cultures in hospitalized patients during a period when rapid diagnostic testing using a FilmArray Blood Culture Identification (BCID) panel was in use. Design: Retrospective cohort study. Setting: Single academic medical center. Participants: Patients who had blood culture(s) performed during an admission between June 2014 and December 2016. Methods: Length of hospital stay and days of antibiotic therapy were assessed in relation to blood-culture contamination using generalized linear models with univariable and multivariable analyses. Results: Among 11,474 patients who had blood cultures performed, the adjusted mean length of hospital stay for patients with contaminated blood-culture episodes (N = 464) was 12.3 days (95% confidence interval [CI], 11.4–13.2) compared to 11.5 days (95% CI, 11.0–11.9) for patients (N = 11,010) with negative blood-culture episodes (P = .032). The adjusted mean durations of antibiotic therapy for patients with contaminated and negative blood-culture episodes were 6.0 days (95% CI, 5.3–6.7) and 5.2 days (95% CI, 4.9–5.4), respectively (P = .011). Conclusions: Despite the use of molecular-based, rapid blood-culture identification, contamination of blood cultures continues to result in prolonged hospital stay and unnecessary antibiotic therapy in hospitalized patients.

scholarly journals Detection of Neisseria meningitidis from Negative Blood Cultures and Cerebrospinal Fluid with the FilmArray Blood Culture Identification Panel

2014 ◽  
Vol 52 (6) ◽  
pp. 2262-2264 ◽  
Author(s):  
J. Pardo ◽  
K. P. Klinker ◽  
S. J. Borgert ◽  
B. M. Butler ◽  
K. H. Rand ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Blood Culture ◽  
Neisseria Meningitidis ◽  
Blood Cultures ◽  
Culture Identification

scholarly journals Effects of two blood culture anticoagulants on growth of Neisseria meningitidis

1978 ◽  
Vol 7 (4) ◽  
pp. 332-336
Author(s):  
L Rintala ◽  
H M Pollock
Keyword(s):  
Blood Culture ◽  
Neisseria Meningitidis ◽  
Yeast Extract ◽  
Brain Heart Infusion ◽  
Inhibitory Effect ◽  
Inoculum Size ◽  
Blood Cultures ◽  
Artificial Blood

Tests of 25 strains of Neisseria meningitidis for sensitivity to sodium polyanethol sulfonate (SPS) showed that the sensitivity of strains varied with both inoculum size and SPS concentration. In Trypticase soy broth (TSB), 2 out of 13 strains were sensitive to 0.05% SPS, whereas 8 out of 13 strains were sensitive to the same concentration of SPS in brain heart infusion (BHI). In artificial blood cultures with six strains of meningococci, the addition of 10% defibrinated blood was found to eliminate the sensitivity of all six strains to SPS in BHI, but not of the two strains in TSB. Addition of 1.2% gelatin to artificial blood cultures eliminated the inhibitory effect of 0.05% SPS, whereas the addition of 1% yeast extract to blood cultures containing 0.025% or 0.05% SPS enhanced the inhibitory effect of this anticoagulant. None of the 13 strains tested was inhibited by 0.05% sodium amylosulfate in TSB or BHI alone or in artificial blood cultures with these media.

scholarly journals Gelatin neutralization of the inhibitory effect of sodium polyanethol sulfonate on Neisseria meningitidis in blood culture media

1977 ◽  
Vol 6 (1) ◽  
pp. 1-3 ◽  
Author(s):  
J Eng ◽  
E Holten
Keyword(s):  
Blood Culture ◽  
Neisseria Meningitidis ◽  
Growth Medium ◽  
Solid Medium ◽  
Culture Media ◽  
Inhibitory Effect ◽  
Blood Cultures ◽  
Nutrient Broth

The inhibitory effect of sodium polyanethol sulfonate (0.05%) upon growth of Neisseria meningitidis was found to be neutralized by adding gelatin (l.1%) to the growth medium. The neutralizing effect was demonstrated in solid medium, as well as in nutrient broth for blood cultures. The findings parallel those of Wilkins and West (6) regarding gelatin neutralization of the inhibitory effect of sodium polyanethol sulfonate on Peptostreptococcus anaerobius.

Impact of Pharmacist Involvement on the Utility of a Gram-Negative Blood Culture Identification Panel on Antimicrobial Usage

2021 ◽  
pp. 875512252110466
Author(s):  
Caitlin Bowman ◽  
Melissa Holloway ◽  
Lisa Scott ◽  
Carmen Russell ◽  
Sonia Lott ◽  
...  
Keyword(s):  
Blood Culture ◽  
Antibiotic Therapy ◽  
Intervention Group ◽  
Pharmacist Intervention ◽  
Small Sample ◽  
Molecular Diagnostic ◽  
Negative Blood Culture ◽  
Gram Negative ◽  
Significant Difference ◽  
The Impact

Background: A rapid molecular diagnostic test (MDT) is a test used to identify several different species of gram-negative bacteria and their genetic resistance markers. However, the impact of rapid MDT has not been established when combined with pharmacist involvement. Objective: To determine the impact of pharmacy involvement on patient outcomes when using rapid MDT. The primary outcome is the time from gram stain result to the first dose of the targeted antibiotic. Methods: This is a single-center, quasi-experimental, 1-group pretest-posttest design study of patients with gram-negative bacteremia in a community hospital. Hospitalized patients 18 years or older were included if they had a gram-negative blood culture. Patients were excluded if they were discharged or expired prior to culture results. Outcomes were compared between patients prior to and after implementation of the automated MDT. This research was determined to be exempt from institutional review board oversight consistent with West Florida Healthcare and in accordance with institutional policy. Results: The use of rapid MDT combined with pharmacist intervention resulted in a statistically significant decrease in the time to targeted antibiotic therapy (pre-intervention group, n = 77, 44.8 ± 17.8 hours versus post-intervention group, n= 80, 4.4 ± 5.8 hours; P ≤.001). There was no significant difference found between secondary outcomes. Limitations included small sample size as well as inconsistent documentation. Conclusions: The use of rapid MDT combined with pharmacist intervention resulted in a statistically significant decrease in the time to targeted antibiotic therapy.

Routine Quantitative Blood Cultures in Children With Haemophilus influenzae or Streptococcus pneumoniae Bacteremia

PEDIATRICS ◽  
1985 ◽  
Vol 76 (6) ◽  
pp. 901-904 ◽  
Author(s):  
Louis M. Bell ◽  
Gershon Alpert ◽  
Joseph M. Campos ◽  
Stanley A. Plotkin
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Severe Disease ◽  
Invasive Disease ◽  
Blood Cultures ◽  
Clinical Value ◽  
Colony Forming Units ◽  
Plating Method ◽  
Focus Of Infection ◽  
Occult Bacteremia

The potential clinical value of quantitative blood cultures determined by a commercially available lysis-direct plating method was studied in 50 children with either Haemophilus influenzae or Streptococcus pneumoniae bacteremia. The magnitude of bacteremia correlated with the severity of the infection; patients with ≥100 colony-forming units per milliliter were significantly more likely to have meningitis (P < .01, χ2 = 7.5). On the other hand, all patients with S. pneumoniae bacteremia with colony counts lower than 15 colony-forming units per milliliter had "occult bacteremia" with no focus of infection. The data suggest that patients with higher levels of bacteremia have more severe disease. Quantitative blood culture results may be helpful in identifying which children are at risk for invasive disease.

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