We reviewed a consecutive case series of 178 immunocompetent children aged 3-36 months without central venous lines who had blood cultures positive for Streptococcus pneumoniae by either of paired broth and quantitative culture methods. The incidence of accompanying focal infection was significantly greater in patients with >10 colony-forming units (cfu)/mL than in patients with <10 cfu/mL (30.4% vs 12.9% respectively, p=0.04). No significant relationships existed between the magnitude of bacteremia and the age, gender, presenting temperature, interval until the blood culture turned positive, total peripheral blood white cell count, absolute neutrophil count, or absolute band count. Overall, the quantitative method detected 59/178 (33.1%) of the isolates, including five isolates (2.8%) that the broth method failed to detect.
Get full access to this article
View all access options for this article.
References
1.
1. McGowan JE Jr, Bratton L, Klein JO, Finland M. Bacteremia in febrile children seen in a “walk-in” pediatric clinic. N Engl J Med. 1973;288:1309-1312.
2.
2. Teele DW, Pelton SI, Grant MJA, et al. Bacteremia in febrile children under two years of age: results of cultures of blood of 600 consecutive febrile children seen in a “walk-in” clinic. J Pediatr. 1975;87:227-230.
3.
3. MMWR1996;45:901-906.
4.
4. Fleisher GR, Rosenberg N, Vinci R, et al. Intramuscular versus oral antibiotics for the prevention of meningitis and other bacterial sequelae in young febrile children at risk for occult bacteremia. J Pediatr. 1994;124:504-512.
5.
5. Baraff LJ, Bass JW, Fleisher GR, et al. Practice guidelines for the management of infants and children 0 to 36 months of age with fever without source. Pediatrics. 1993;92:1-12.
6.
6. Wing EJ, Norden CW, Shadduck RK, et al. Use of quantitative bacteriologic techniques to diagnose catheter-related sepsis. Arch Intern Med. 1979; 139:482-483.
7.
7. Pazin GJ, Peterson KL, Griff FW. Determination of the site of infection in endocarditis. Ann Intern Med. 1975; 82:746-750.
8.
8. Santosham M, Moxon ER. Detection and quantitation of bacteremia in childhood. J Pediatr. 1977;91:719-721.
9.
9. Durbin WA, Szymczak EG, Goldmann DA. Quantitative blood cultures in childhood bacteremia. J Pediatr. 1978;92:778-780.
10.
10. Lascolea LJ, Dryja DM, Neter E. Comparison of the quantitative direct plating method and the BACTEC procedure for rapid diagnosis of Haemophilus influenzae bacteremia in children. J Clin Microbiol. 1981;14:661-664.
11.
11. Lascolea LJ, Dryja DM, Sullivan TD, et al. Diagnosis of bacteremia in children by quantitative direct plating and a radiometric procedure. J Clin Microbiol. 1981;13:478-482.
12.
12. Sullivan TD, LaScolea LJ, Neter E. Relationship between the magnitude of bacteremia in children and the clinical disease. Pediatrics. 1982;69:699-702.
13.
13. LaScolea LJ, Dryja DM. Quantitation of bacteria in cerebrospinal fluid and blood of children with meningitis and its diagnostic significance. J Clin Microbiol. 1984;19:187-190.
14.
14. LaScolea LJ, Rosales SV, Welliver RC, Ogra PL. Mechanisms underlying the development of meningitis or epiglottitis in children after Haemophilus influenzae type b bacteremia. J Infect Dis. 1985;151:1162-1165.
15.
15. Bell LM, Alpert G, Campos JM, Plotkin SA. Routine quantitative blood cultures in children with Haemophilus influenzae or Streptococcus pneumoniae bacteremia. Pediatrics. 1985;76:901-904.
16.
16. Welch DF, Scribner RK, Hensel D. Evaluation of a lysis direct plating method for pediatric blood cultures. J Clin Microbiol. 1985;21:955-958.
17.
17. Sullivan TD, LaScolea LJ. Neisseria meningitidis bacteremia in children: quantitation of bacteremia and spontaneous clinical recovery without antibiotic therapy. Pediatrics. 1987;80:63-67.
18.
18. Marshall GS, Bell LM. Correlates of high-grade and low-grade Haemophilus infiuenzae bacteremia. Pediatr Infect Dis J. 1988;7:86-90.
19.
19. Isaacman DJ, Karasic RB, Reynolds EA, Kost SI. Effect of number of blood cultures and volume of blood on detection of bacteremia in children. J Pediatr. 1996;128:190-195.
20.
20. Bennett IL, Beeson PB. Bacteremia: a consideration of some experimental and clinical aspects. Yale J Biol Med. 1954:92;778-780.
21.
21. Campos JM, Spainhour JR. Rapid detection of bacteremia in children with a modified lysis direct plating method. J Clin Microbiol. 1985;22:674-676.
