Abstract
Background: Febrile neutropenia is a common reason for the hospitalization of pediatric oncology patients. The initiation of antibiotics and the overall decline in rates of bacteremia, would predict a low yield of detection of bacteremia in repeated blood cultures. Despite little evidence supporting the utility of serial cultures, repeat culturing with fever persists. Procedure: To determine the rate of follow-up blood culture growth when the initial blood culture showed no bacterial growth and patient risk factors for this occurrence, we reviewed the records of oncology patients admitted to the Children's Hospital at Montefiore Pediatric Hematology/Oncology service for febrile neutropenia from 2004 to 2009. Results: We identified 457 febrile neutropenia episodes in 137 patients. The initial blood culture was positive in 84 episodes (18.4%). In 220 episodes comprising 105 patients, the initial blood culture was negative and a subsequent culture was obtained. In 24 episodes (10.9%), bacterial growth was detected in the repeat culture. Risk factors included a previous history of bacteremia and hospitalization for more than 48hours prior to onset of fever. Conclusions: In patients with febrile neutropenia, bacteremia is detected nearly twice as frequently in initial blood cultures than in repeat blood cultures obtained when the initial blood culture is negative. Despite an initial negative blood culture, bacteremia can be detected in more than 10% of episodes when a repeat blood culture is obtained. The risk more than doubles for patients with a previous history of bacteremia or hospitalized for more than 48hours prior to the onset of fever.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 923-927 |
| Number of pages | 5 |
| Journal | Pediatric Blood and Cancer |
| Volume | 60 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2013 |
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Keywords
- Bacteremia
- Blood culture
- Febrile neutropenia
ASJC Scopus subject areas
- Oncology
- Pediatrics, Perinatology, and Child Health
- Hematology
Cite this
Repeating blood cultures in neutropenic children with persistent fevers when the initial blood culture is negative. / Rosenblum, Jeremy; Lin, Juan; Kim, Mimi; Levy, Adam S.
In: Pediatric Blood and Cancer, Vol. 60, No. 6, 06.2013, p. 923-927.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Repeating blood cultures in neutropenic children with persistent fevers when the initial blood culture is negative
AU - Rosenblum, Jeremy
AU - Lin, Juan
AU - Kim, Mimi
AU - Levy, Adam S.
PY - 2013/6
Y1 - 2013/6
N2 - Background: Febrile neutropenia is a common reason for the hospitalization of pediatric oncology patients. The initiation of antibiotics and the overall decline in rates of bacteremia, would predict a low yield of detection of bacteremia in repeated blood cultures. Despite little evidence supporting the utility of serial cultures, repeat culturing with fever persists. Procedure: To determine the rate of follow-up blood culture growth when the initial blood culture showed no bacterial growth and patient risk factors for this occurrence, we reviewed the records of oncology patients admitted to the Children's Hospital at Montefiore Pediatric Hematology/Oncology service for febrile neutropenia from 2004 to 2009. Results: We identified 457 febrile neutropenia episodes in 137 patients. The initial blood culture was positive in 84 episodes (18.4%). In 220 episodes comprising 105 patients, the initial blood culture was negative and a subsequent culture was obtained. In 24 episodes (10.9%), bacterial growth was detected in the repeat culture. Risk factors included a previous history of bacteremia and hospitalization for more than 48hours prior to onset of fever. Conclusions: In patients with febrile neutropenia, bacteremia is detected nearly twice as frequently in initial blood cultures than in repeat blood cultures obtained when the initial blood culture is negative. Despite an initial negative blood culture, bacteremia can be detected in more than 10% of episodes when a repeat blood culture is obtained. The risk more than doubles for patients with a previous history of bacteremia or hospitalized for more than 48hours prior to the onset of fever.
AB - Background: Febrile neutropenia is a common reason for the hospitalization of pediatric oncology patients. The initiation of antibiotics and the overall decline in rates of bacteremia, would predict a low yield of detection of bacteremia in repeated blood cultures. Despite little evidence supporting the utility of serial cultures, repeat culturing with fever persists. Procedure: To determine the rate of follow-up blood culture growth when the initial blood culture showed no bacterial growth and patient risk factors for this occurrence, we reviewed the records of oncology patients admitted to the Children's Hospital at Montefiore Pediatric Hematology/Oncology service for febrile neutropenia from 2004 to 2009. Results: We identified 457 febrile neutropenia episodes in 137 patients. The initial blood culture was positive in 84 episodes (18.4%). In 220 episodes comprising 105 patients, the initial blood culture was negative and a subsequent culture was obtained. In 24 episodes (10.9%), bacterial growth was detected in the repeat culture. Risk factors included a previous history of bacteremia and hospitalization for more than 48hours prior to onset of fever. Conclusions: In patients with febrile neutropenia, bacteremia is detected nearly twice as frequently in initial blood cultures than in repeat blood cultures obtained when the initial blood culture is negative. Despite an initial negative blood culture, bacteremia can be detected in more than 10% of episodes when a repeat blood culture is obtained. The risk more than doubles for patients with a previous history of bacteremia or hospitalized for more than 48hours prior to the onset of fever.
KW - Bacteremia
KW - Blood culture
KW - Febrile neutropenia
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U2 - 10.1002/pbc.24358
DO - 10.1002/pbc.24358
M3 - Article
VL - 60
SP - 923
EP - 927
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
SN - 1545-5009
IS - 6
ER -