Clinical Significance of Isolates Known to Be Blood Culture Contaminants in Pediatric Patients

Background and objectives: The objective of this study was to investigate the clinical significance of isolates from blood stream infection known to be blood culture contaminants in pediatric patients. Materials and Methods: Microbiological reports and medical records of all blood culture tests issued from 2002 to 2012 (n = 76,331) were retrospectively reviewed. Evaluation for potential contaminants were done by reviewing medical records of patients with the following isolates: coagulase-negative Staphylococcus, viridans group Streptococcus, Bacillus, Corynebacterium, Micrococcus, Aerococcus, and Proprionibacterium species. Repeated cultures with same isolates were considered as a single case. Cases were evaluated for their status as a pathogen. Results: Coagulase-negative Staphylococcus had clinical significance in 23.8% of all cases. Its rate of being a true pathogen was particularly high in patients with malignancy (43.7%). Viridans group Streptococcus showed clinical significance in 46.2% of all cases. Its rate of being a true pathogen was similar regardless of the underlying morbidity of the patient. The rate of being a true pathogens for remaining isolates was 27.7% for Bacillus and 19.0% for Corynebacterium species. Conclusions: Coagulase-negative Staphylococcus and viridans group Streptococcus isolates showed high probability of being true pathogens in the pediatric population, especially in patients with underlying malignancy.

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851. Compliance with Guidelines for Management of Staphylococcus aureus Bacteremia and its Effect on Mortality

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1040 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S466-S466

Author(s):

Robert D Travez ◽

Anjuli Eagleston ◽

Dominique Brandt ◽

Stephen Blatt

Keyword(s):

Staphylococcus Aureus ◽

Blood Culture ◽

Infectious Diseases ◽

Blood Stream Infection ◽

Blood Stream ◽

Population Characteristics ◽

Coagulase Negative Staphylococcus ◽

Staphylococcus Aureus Bacteremia ◽

Alternative Treatment Strategy ◽

Infectious Diseases Consultation

Abstract Background In the US, Staphylococcus aureus Bacteremia (SAB) occurs in about 19.7 /100,000 people. A recent increase in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia infections rate and mortality has led to more infectious diseases (ID) consultations. We assessed if an infectious diseases consultation within 7 days of initial blood culture results was associated to greater compliance with Infectious Diseases Society of America (IDSA) guidelines for managing Staphylococcus aureus bacteremia and a decrease in all-cause mortality and relapse within 90 days. Methods A retrospective cohort of patients admitted to two community hospitals from January 2014 to June 2016 with a positive blood culture for methicillin-susceptible S. aureus (MSSA), MRSA, or coagulase-negative Staphylococcus were included in the study. I. Patients were excluded if they were immunocompromised, had a polymicrobial blood stream infection, died within first 48 hours of admission, left against medical advice during treatment or participated in another study requiring an alternative treatment strategy. Results A total of 331 patients were included in the analysis. A significantly higher proportion of patients with complicated SAB had an ID consult (61% vs. 17.5%, p< .0001) and for uncomplicated SAB the reverse was true (39% vs 79%, P< .0001). An ID consult was associated with increased compliance with IDSA guidelines (75% vs. 5%, p< .0001). Patients with an ID consult had a significantly higher duration of antibiotic treatment [30(14-42) vs. 5(1.5-12), p< .0001], an earlier start of treatment in number of days [0(0-7) vs. 0(0-12), p=0.036] and a lower mortality within 90 days of blood culture (61% vs. 17.5%, p< .0001). Logistic regression model showed than an ID consult reduced 90-day mortality by 69%, OR 0.313[CI 95 %(0.313-0.154), p=0.001] and transesophageal echography by 78%, OR 0.228[CI 95 %(0.228-0.052), p=0.05]. Population characteristics and outcomes Conclusion ID consultation in the setting of SAB has been shown to increase compliance with IDSA guidelines and reduce 90-day mortality. Disclosures All Authors: No reported disclosures

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Clinical, genetical and microbiological characterization of pediatric patients with Cystic Fibrosis in Ecuador

10.21203/rs.2.12767/v1 ◽

2019 ◽

Author(s):

Yazmina Lascano-Vaca ◽

Esteban Ortiz-Prado ◽

Lenin Gomez-Barreno ◽

Katherine Simbaña-Rivera ◽

Eduardo Vasconez ◽

...

Keyword(s):

Cystic Fibrosis ◽

Electronic Medical Records ◽

Medical Records ◽

Pediatric Patients ◽

Pediatric Population ◽

Coagulase Negative Staphylococcus ◽

Cross Sectional ◽

Gram Positive Bacteria ◽

Sectional Analysis

Abstract Summary Objective To characterize the epidemiology and the clinical, pathological, microbiological and genetical profile of children with cystic fibrosis treated in Ecuador. Methods We conducted a cross-sectional analysis of the pediatric population with a confirmed diagnosis of cystic fibrosis (CF) attending to one of the biggest III-level hospitals in Ecuador. All demographic, clinical and genetical variables were obtained from the electronic medical records (EMR) from 2017-2018. Results 47 patients with CF were observed and followed for more than a year. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV1/FVC) changed significantly after 9 months post-diagnosis (85.55 ± 13.26; p <0.05). The most common pathogenic genetical mutation was F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13) and the G85E and the N1303K with 11.11% respectively (n = 3). Finally, there were 14.1% (n = 7) of patients with a mutation g.204099A> C, which has only been reported among Ecuadorians. Conclusions This is the first study carried out in Ecuador exploring the clinical, genetical and bacteriological analysis of patients with CF. Children with CF are often colonized by four species of gram-positive bacteria (S. aureus, Coagulase-Negative Staphylococcus, Streptococcus pneumoniae and M. catarrhalis) were the most predominant this condition atients were hospitalized for complications related to cystic fibrosis, with an average of 19 days of stay.

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Effectiveness of a central line associated blood stream infection protocol in a pediatric population

The American Journal of Surgery ◽

10.1016/j.amjsurg.2021.02.023 ◽

2021 ◽

Author(s):

John S. Graham ◽

Michelle Shroyer ◽

Scott A. Anderson ◽

Cecelia Hutto ◽

Kathy Monroe ◽

...

Keyword(s):

Blood Stream Infection ◽

Pediatric Population ◽

Blood Stream ◽

Central Line

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Frequency and Microbiological Profile of Catheter-Related Infections in Hemodialysis Patients Receiving Gentamicin as Antimicrobial Lock Therapy for Prophylaxis

Pakistan Journal of Kidney Diseases ◽

10.53778/pjkd40350 ◽

2021 ◽

Vol 4 (03) ◽

Author(s):

Sumbal Nasir Mahmood ◽

Sabaa Asif ◽

Muhammad Amim Anwar ◽

Osama Kunwer Naveed

Keyword(s):

Blood Culture ◽

Blood Stream Infection ◽

Blood Stream ◽

Cross Sectional Study ◽

Immunosuppressive Drugs ◽

Hemodialysis Patients ◽

Exit Site ◽

Cross Sectional ◽

Exit Site Infection ◽

Antibiotic Lock

Antibiotic lock solution (ALS) in the lumen of catheter is a mean to decrease the possibility of catheter related blood stream infection (CRBSI). We conducted this study using Gentamicin as ALS to observe the frequency of catheter related infections (CRI) including CRBSI and exit site infection in this hemodialysis patients being dialyzed through tunneled and temporary hemodialysis catheters. Methods This descriptive, cross sectional study was conducted at Dr. Ziauddin Hospital, North Campus between January 2017- December 2017. Symptomatic patients for CRBSI were included in this study. Blood culture from the catheter ports and periphery and exit site swab if pus visible were sent for culture sensitivity. Results Total 138 patients of either gender with age more than 18 years to less than 80 years were evaluated. 44.9% were male and mean age of patients was 58.79±14.05 years. 70.3% patients were diabetic for 15.61±4.61 years and 11.6% were using immunosuppressive drugs. The overall mean catheter duration was 22.27±14.39 days and mean hemodialysis duration was 25.32±44.31 weeks. Tunneled catheter was placed in 40.6% and 46.4% had femoral temporary catheters. Blood culture was done for 51 cases and 21.5% were positive. Tip culture was positive in 33.3% patients. In our study, 23.18% patients were found to have catheter related infections, out of which 61.5% were found with gentamicin resistance including colonization. Conclusion We report a high frequency of catheter related infections despite using ALS as prophylaxis, with predominant organisms being gram positives and a high incidence of gentamycin resistance.

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TEICOPLANIN RESISTANCE IN GRAM-POSITIVE BACTERIAL ISOLATE: AN EMERGING THREAT

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i12.43332 ◽

2021 ◽

pp. 136-139

Author(s):

SATISH CHANDEL ◽

PARAG SHARMA ◽

PRATIK AKHANI ◽

RAMESH AGRAWAL

Keyword(s):

Blood Culture ◽

Blood Stream Infection ◽

Central India ◽

Blood Stream ◽

Diffusion Method ◽

Gram Positive ◽

Disk Diffusion Method ◽

Gram Positive Bacteria ◽

Antibiotic Susceptibility Test ◽

The Future

Objectives: Development of antimicrobial resistance in microorganism isolated from blood stream infection constitutes a major concern about their treatment. Teicoplanin is a glycopeptide antibiotic used in the treatment of infection caused by Gram-positive bacteria. This study was planned to determine Teicoplanin resistance in the Central India and recommend policy changes for prevention of the future resistance to the higher antibiotics. Methods: A total of 1855 septicemia suspected blood samples were studied. The blood culture samples were processed and identified in the microbiology laboratory according to the Clinical and Laboratory Standards Institute guidelines. Antibiotic susceptibility test was done using Kirby B disk diffusion method. Results: About 39.5% of blood culture samples showed positive growth for organism. We observed high teicoplanin resistance (29.5%) among Gram-positive isolates, predominantly (53%) in the Enterococcus species. Conclusion: Teicoplanin resistance has emerged tremendously in the present study. Hence, attention is required about this serious issue otherwise very limited choice of antibiotics will be available for treating infections in the future.

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Evaluation of the Association of Bacteraemia with the Severity of Neutropenia

Haematology Journal of Bangladesh ◽

10.37545/haematoljbd20176 ◽

2017 ◽

Vol 1 (01) ◽

pp. 13-15

Author(s):

Md. Kamrul Hasan ◽

Amin Lutful Kabir ◽

Adnan Hasan Masud ◽

Md. Mahbubur Rahman

Keyword(s):

Blood Culture ◽

Febrile Neutropenia ◽

Blood Stream Infection ◽

Prophylactic Antibiotic ◽

Blood Stream ◽

Febrile Episode ◽

Severe Neutropenia ◽

Management Algorithm ◽

Blood Culture Positivity ◽

Neutropenic Patients

Background: Blood culture is a part of management algorithm in febrile neutropenia. However, the incidence of positive result of blood culture is decreasing and the spectrum of the causative microbial is changing over time. Objective: The objective of this study was to see the incidence of bacteraemia and its association with the severity of neutropenia. Methodology: Based on naturally occurring blood stream infection, we evaluated 47 febrile neutropenic patients using blood culture to see the incidence of bacteraemia during the period between October 2009 and October 2010. Results: The overall rate of blood culture positivity was 17% (8/47). It was found to be significantly higher in 32% (8/25) (p = 0.014) of patients with very severe neutropenia, 26.9% (7/26) (p = 0.044) positivity was found when blood culture was done on the first day of febrile episode and 41.7% (5/12) (P = 0.008) in the absence of prophylactic antibiotic. Conclusion: Blood culture was found to be a valuable tool for the evaluation of bacteraemia and should be used in all cases of febrile neutropenia.

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Hub colonization of central line catheters in children with cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.18530 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 18530-18530 ◽

Cited By ~ 1

Author(s):

R. Norville ◽

B. Horvath ◽

D. Lee ◽

A. Hyde ◽

M. Gregurich ◽

...

Keyword(s):

Central Venous Catheter ◽

Blood Stream Infection ◽

Significant Risk ◽

Venous Catheter ◽

Blood Stream ◽

Coagulase Negative Staphylococcus ◽

Urban Hospital ◽

Central Venous ◽

Children With Cancer ◽

Convenience Sample

18530 Background: Central venous catheter (CVC) hub sites provide bacterial access to the blood stream through migration along the external and internal surfaces of the catheter. Hub colonization rates vary from 29–38% in the adult literature. While pediatric studies were not found, one study reported the incidence of blood stream infections in neonates to be 30 times higher in catheters with hub colonization compared to catheter hubs that were not colonized. The purpose of this descriptive study was to obtain baseline cultures of CVC hubs to determine the incidence of colonization. Methods: Fifty-one catheter hub cultures were obtained from a convenience sample of 27 children with cancer. The mean age of the patients was 8.2 years (range 0.5–16.2 years); 77% were diagnosed with leukemia and 23% with solid tumors. Cultures were obtained by swabbing the threaded area of the catheter hub after removing the injection cap. A semi-quantitative culture for bacteria and fungus was obtained using standard laboratory procedures by a microbiologist. This study was conducted in a large urban hospital in the Southwest. Results: Fifty-seven percent of the hubs were culture positive. Of those positive cultures, 69%, 24%, 10% and 7% were colonized with 2, 3, 4 and 5 organisms, respectively. The most common organism cultured was coagulase negative staphylococcus. The only significant risk factor for this population was previous central venous catheter infections (p = 0.025). Sixty-nine percent of the lines were tunneled catheters. Central venous catheters were in place on an average of 75.3 days but this was not a factor in the colonization rate. Conclusions: The majority (57%) of the 51 central venous catheter hubs cultured were colonized with at least one organism. This study is the first to evaluate the rate of central venous catheter hub colonization in children with cancer. These findings support the need for more stringent guidelines for central venous catheter care. Further research evaluating the relationship between hub colonization and subsequent blood stream infection is needed. No significant financial relationships to disclose.

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Coagulase Negative Staphylococcus; A Cause of Nosocomial Blood Stream Infection

International Journal of Scientific Research ◽

10.15373/22778179/june2014/88 ◽

2012 ◽

Vol 3 (6) ◽

pp. 277-278

Author(s):

Dr.Sadhvi Parashar ◽

Keyword(s):

Blood Stream Infection ◽

Blood Stream ◽

Coagulase Negative Staphylococcus

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183. Candidaemia in Children and Importance of Central Venous Catheter Removal

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.258 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S112-S113

Author(s):

Kamile Arikan ◽

Sevtap Arıkan-Akdaglı ◽

Ates Kara

Keyword(s):

Blood Culture ◽

Central Venous Catheter ◽

Blood Stream Infection ◽

Tertiary Care ◽

Venous Catheter ◽

Blood Stream ◽

Attributable Mortality ◽

Care Hospital ◽

Central Venous ◽

Candida Spp

Abstract Background Candida is the most common cause of invasive fungal infection in healthcare settings and is associated with significant increases in healthcare resource utilization and attributable mortality. Methods This study was conducted in a pediatric tertiary care hospital from Turkey. We conducted a retrospective analysis in children ≤18 years with blood culture-proven candidaemia identified between December 2013 and November 2017. Sociodemographic variables,underlying condition, mortality, additional risk factors, origin of specimens were all recorded. Results A total of 236 episodes of candidaemia were identified over the study period. The median age of the patients was 600 days (4-6482). 106 specimens (44.9%) were cultured from patients under 1 year of age and 15 of 106 specimens were cultured from neonates. The most frequently isolated Candida spp. were C. albicans (42.%), followed by C. parapsilosis (30.5%), C. glabrata (7.6%), C. tropicalis (6.4%), C. krusei (2.5%), C. lusitaine (2.5%), C. dubliniensis (2.1%), C. kefir (0.8%), and C. pelliculosa (0.4%). In 11 of the 236 episodes (4.5%), two Candida spp were cultured at the same time.The most common coinfection was C. albicans and C. parapsilosis. 112 of the 236 episodes (47.5%) was due to central venous catheter-related blood stream infection. 47.5% of these patients were receiving total parenteral nutrition at the time of candidemia. Concomitant coagulase negatif staphylococcus bacteremia was present in 50 of 236 candidemia episodes (21.2%). Of 236 isolates, 74 (31.4%) was cultured from peripheral blood culture only, 95 (40.3%) from central venous catheter only, 67 (28.4%) from both peripheral and central catheter blood culture.Trombocytopenia was noted in 117 episodes (49.6%) and neutropenia in 45 episodes (19.1 Of the 112 central venous catheter-related candidemia, 35 (31.3%) resulted in death within 30 days from the onset of candidaemia (Figure 1). In 49 (45.%) episodes of central venous catheter-related candidemia, catheter was not removed and 40% of these episodes resulted as death.Catheter removal, thrombocytopenia, total parenteral nutrion were found to be associated with increased mortality in children under 1 year of age (P < 0.001). Conclusion Clinicians must be aware of candidemia in children due to high risk of mortality. Disclosures All authors: No reported disclosures.

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