Sections of General and Community Pediatrics, The University of Oklahoma, Oklahoma City, OK, USA.
Pediatrics. 2013 Sep;132(3):454-9. doi: 10.1542/peds.2013-1384. Epub 2013 Aug 5.
Blood cultures are often obtained in children hospitalized with skin and soft tissue infections (SSTIs). Because little evidence exists to validate this practice, we examined the yield of blood cultures in the evaluation of immunocompetent children with SSTIs.
Medical records were reviewed for all children admitted between January 1, 2007 and December 31, 2009 after emergency department evaluation and diagnosis of cellulitis or abscess. We compared patients with SSTIs (n = 482) with those with complicated SSTIs (cSSTIs; n = 98). A cSSTI was defined as surgical or traumatic wound infection, need for surgical intervention, or infected ulcers or burns. The SSTI group included patients without complicating factors.
None of the patients in the SSTI group had a positive blood culture. In the cSSTI group, 12.5% of blood cultures were positive. The mean length of hospital stay (LOHS) of children with SSTIs was shorter than that of those with cSSTIs (P < .001). In the SSTI group, obtaining a blood culture was associated with a higher mean LOHS (P = .044).
Blood cultures are not useful in evaluating immunocompetent children who are admitted to the hospital with uncomplicated SSTIs, and they are associated with a nearly 1-day increase in mean LOHS.
患有皮肤和软组织感染（SSTIs）的住院患儿通常会进行血培养。由于几乎没有证据可以验证这种做法，因此我们研究了血培养在评估免疫功能正常的 SSTIs 患儿中的效果。
回顾了 2007 年 1 月 1 日至 2009 年 12 月 31 日期间因蜂窝织炎或脓肿在急诊科就诊并诊断为蜂窝织炎或脓肿的所有患儿的病历。我们比较了患有 SSTIs（n=482）的患者与患有复杂 SSTIs（cSSTIs；n=98）的患者。cSSTI 的定义为手术或创伤性伤口感染、需要手术干预、或感染性溃疡或烧伤。SSTI 组不包括有并发症的患者。
SSTI 组的患者均未培养出阳性血培养。cSSTI 组有 12.5%的血培养阳性。SSTI 组患儿的平均住院时间（LOHS）短于 cSSTI 组（P<.001）。在 SSTI 组中，血培养与较长的平均 LOHS 相关（P=0.044）。
对于无并发症的 SSTIs 住院患儿，血培养对评估病情无帮助，而且与平均 LOHS 增加近 1 天相关。
