What is the prevalence of bacteremia in children hospitalized with community-acquired pneumonia?

Approximately one third of this cohort of 7509 children hospitalized with community-acquired pneumonia (and no comorbidities) had a blood culture performed, of which only 2.5% grew a pathogen. The majority of those pathogens were identified as Streptococcus pneumoniae and were susceptible to penicillin. Among the 2568 blood cultures, only 11 (0.43%) grew a pathogen that was not susceptible to penicillin. (LOE = 2b)

Neuman MI, Hall M, Lipsett SC, et al, for the Pediatric Research in Inpatient Settings Network. Utility of blood culture among children hospitalized with community-acquired pneumonia. Pediatrics 2017;140(3):e20171013.  [PMID:28835382]

Cross-sectional

Government

Uncertain

Inpatient (ward only)

Using a health administrative database from 6 US tertiary children's hospitals, these investigators evaluated the prevalence of bacteremia in 7509 children aged 3 months to 18 years who were hospitalized with community-acquired pneumonia. (Children transferred from other hospitals and those with complex chronic conditions were excluded.) Of this cohort, 34% had a blood culture performed on day 1 or day 2 of the hospitalization. Overall, 2.5% of the blood cultures grew pathogens and 1% contained contaminants. Of the pathogens, 78% were identified as S. pneumoniae. Susceptibility to penicillin was tested on 61 of the 65 pathogens detected: 50 (82%) were susceptible, and the remaining 11 nonsusceptible pathogens represented 0.4% of the children from whom a blood culture was obtained. The rate of bacteremia in the subgroup of patients with severe or complicated pneumonia (ie, those who were admitted to the intensive care unit or required pleural drainage in the first or second day of hospitalization) was twice that of those without these factors present (4.2% vs 2.2%).