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The Volume of Pediatric Blood Culture

2019; Lippincott Williams & Wilkins; Volume: 38; Issue: 12 Linguagem: Inglês

10.1097/inf.0000000000002466

1532-0987

Yoshiki Kusama, Nobuaki Shime, Kenta Ito, Yusuke Ito, Masashi Kasai,

Neutropenia and Cancer Infections

To The Editors: We read the article by Theodosiou et al1 with great interest. From clinical viewpoint, we agree with the authors' conclusion that 24 hours of incubation is appropriate to make the first decision for antimicrobial cessation. It was also interesting to find that the rate of true bacteremia was surprisingly as low as 0.6% of all the blood cultures taken, and was merely one-fourth of the total positive blood cultures. We consider that this paper is important in the era of antimicrobial stewardship. However, as mentioned by the authors in the "Limitations" section, lack of information on blood volume is a major concern. The volume of blood culture affects both the sensitivity and specificity in children. According to past studies, the lower the volume taken, lower is the detection ratio,2 and higher is the contaminant ratio.3 We have developed a volunteer group for pediatric blood culture education. The responses in the questionnaires distributed to participants during the workshop revealed that only 52% of the participants drew appropriate blood volume (1–3 mL) for pediatric bottle, and only 55% for adult bottle (8–10 mL). Further, 34% of the participants believed that there was a room for improvement in their clinical practice for the volume of blood culture. Thus, the arguments for the blood volume have been scarce. It would be necessary to raise concerns, increase awareness for the blood volume, and improve quality assurance for obtaining pediatric blood culture samples. Yoshiki Kusama, MDAMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, JapanNobuaki Shime, MD, PhDDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan, All the authors belong to the KOKETSUKIN pediatric blood culture education groupKenta Ito, MDDepartment of General Pediatrics, Aichi Children's Health and Medicine Hospital, Aichi, JapanYusuke Ito, MDDepartment of Infectious disease, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, JapanMasashi Kasai, MDDivision of Infectious disease, Department of Pediatrics, Kobe Children Hospital, Hyogo, Japan