Davis Tessa R, Evans Hannah R, Murtas Jennifer, Weisman Aimee, Francis J Lynn, Khan Ahmed
Department of Paediatrics, Sydney Children's Hospital, Sydney, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
J Paediatr Child Health. 2017 Mar;53(3):232-236. doi: 10.1111/jpc.13376. Epub 2016 Oct 7.
The aim of the study was to assess the utility of blood cultures in children admitted to hospital with community-acquired pneumonia. The primary outcome was the number of positive blood culture results, and secondary outcomes included the effect of positive blood culture results on management, and the identification of other clinical/biochemical variables that could predict blood culture results or the course of illness.
A retrospective data analysis was carried out on all children admitted to Gosford Hospital during the 2-year period from July 2013 to June 2015. Included were patients under 16 years old who had a diagnosis-related group code of pneumonia. A review of blood culture results, chest X-ray, serology, C-reactive protein and white cell count and clinical outcomes were analysed.
There were 215 paediatric admissions with a diagnosis of pneumonia during the 2-year study period. A blood culture was collected in 82.3% (177/215). Although seven had a positive blood culture, only two of these were finally reported as true positives and both were Streptococcus pneumoniae. Both patients were treated with a cephalosporin and demonstrated clinical improvement. No changes were made to their treatment based on the blood culture results.
Blood cultures have a low yield and do not appear to be helpful when collected in all patients admitted to hospital with community-acquired pneumonia.
本研究旨在评估血培养在因社区获得性肺炎入院儿童中的应用价值。主要结局是血培养阳性结果的数量，次要结局包括血培养阳性结果对治疗管理的影响，以及识别其他能够预测血培养结果或疾病进程的临床/生化变量。
对2013年7月至2015年6月这两年期间入住戈斯福德医院的所有儿童进行回顾性数据分析。纳入的是诊断相关组编码为肺炎的16岁以下患者。分析血培养结果、胸部X线、血清学、C反应蛋白、白细胞计数及临床结局。
在为期两年的研究期间，有215例儿科患者因肺炎入院。82.3%（177/215）的患者进行了血培养。虽然有7例血培养阳性，但最终仅2例被报告为真阳性，且均为肺炎链球菌。两名患者均接受了头孢菌素治疗，临床症状改善。治疗方案未根据血培养结果进行调整。
血培养阳性率较低，对于所有因社区获得性肺炎入院的患者进行血培养似乎并无帮助。
