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P48 The limited yield of cultures in the critically ill child

BACKGROUND: Broad-spectrum antimicrobial therapy is a key driver of antimicrobial resistance. Here, we aimed to review indications for antimicrobial therapy, determine the proportion of suspected bacterial infections that are confirmed by culture, and assess the time taken for microbiology test resu...

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Autores principales: Clark, John, White, Deborah, Daubney, Esther, Curran, Martin, Bousfield, Rachel, Gouliouris, Theodore, Powell, Elizabeth, Palmer, Adam, Agrawal, Shruti, Inwald, David, Kean, Iain, Török, M. Estée, Baker, Stephen, Pathan, Nazima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849361/
http://dx.doi.org/10.1093/jacamr/dlac004.047
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author Clark, John
White, Deborah
Daubney, Esther
Curran, Martin
Bousfield, Rachel
Gouliouris, Theodore
Powell, Elizabeth
Palmer, Adam
Agrawal, Shruti
Inwald, David
Kean, Iain
Török, M. Estée
Baker, Stephen
Pathan, Nazima
author_facet Clark, John
White, Deborah
Daubney, Esther
Curran, Martin
Bousfield, Rachel
Gouliouris, Theodore
Powell, Elizabeth
Palmer, Adam
Agrawal, Shruti
Inwald, David
Kean, Iain
Török, M. Estée
Baker, Stephen
Pathan, Nazima
author_sort Clark, John
collection PubMed
description BACKGROUND: Broad-spectrum antimicrobial therapy is a key driver of antimicrobial resistance. Here, we aimed to review indications for antimicrobial therapy, determine the proportion of suspected bacterial infections that are confirmed by culture, and assess the time taken for microbiology test results to become available in the paediatric ICU (PICU). METHODS: A single-centre prospective observational cohort study of 100 consecutive general PICU admissions from 30 October 2019 to 19 February 2020. Data were collected from the hospital medical record and entered into a study database prior to statistical analysis using standard methods. RESULTS: Of all episodes of suspected infection, 22% of lower respiratory tract infection, 43% of bloodstream and 0% of central nervous system infection were associated with growth on microbiology culture. Ninety percent of children received antimicrobial therapy. Hospital-acquired infection occurred less commonly than primary infection, but an organism was grown in a greater proportion (64%) of cultures. Final laboratory reports for negative cultures were issued at a median of 120.3 h for blood cultures and 55.5 h for endotracheal tube aspirate cultures. CONCLUSIONS: Despite most critically children receiving antimicrobial therapy, infection was often not microbiologically confirmed. Novel molecular diagnostics may improve rationalization of treatment in this population.
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spelling pubmed-88493612022-02-17 P48 The limited yield of cultures in the critically ill child Clark, John White, Deborah Daubney, Esther Curran, Martin Bousfield, Rachel Gouliouris, Theodore Powell, Elizabeth Palmer, Adam Agrawal, Shruti Inwald, David Kean, Iain Török, M. Estée Baker, Stephen Pathan, Nazima JAC Antimicrob Resist Posters Abstracts BACKGROUND: Broad-spectrum antimicrobial therapy is a key driver of antimicrobial resistance. Here, we aimed to review indications for antimicrobial therapy, determine the proportion of suspected bacterial infections that are confirmed by culture, and assess the time taken for microbiology test results to become available in the paediatric ICU (PICU). METHODS: A single-centre prospective observational cohort study of 100 consecutive general PICU admissions from 30 October 2019 to 19 February 2020. Data were collected from the hospital medical record and entered into a study database prior to statistical analysis using standard methods. RESULTS: Of all episodes of suspected infection, 22% of lower respiratory tract infection, 43% of bloodstream and 0% of central nervous system infection were associated with growth on microbiology culture. Ninety percent of children received antimicrobial therapy. Hospital-acquired infection occurred less commonly than primary infection, but an organism was grown in a greater proportion (64%) of cultures. Final laboratory reports for negative cultures were issued at a median of 120.3 h for blood cultures and 55.5 h for endotracheal tube aspirate cultures. CONCLUSIONS: Despite most critically children receiving antimicrobial therapy, infection was often not microbiologically confirmed. Novel molecular diagnostics may improve rationalization of treatment in this population. Oxford University Press 2022-02-16 /pmc/articles/PMC8849361/ http://dx.doi.org/10.1093/jacamr/dlac004.047 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Posters Abstracts
Clark, John
White, Deborah
Daubney, Esther
Curran, Martin
Bousfield, Rachel
Gouliouris, Theodore
Powell, Elizabeth
Palmer, Adam
Agrawal, Shruti
Inwald, David
Kean, Iain
Török, M. Estée
Baker, Stephen
Pathan, Nazima
P48 The limited yield of cultures in the critically ill child
title P48 The limited yield of cultures in the critically ill child
title_full P48 The limited yield of cultures in the critically ill child
title_fullStr P48 The limited yield of cultures in the critically ill child
title_full_unstemmed P48 The limited yield of cultures in the critically ill child
title_short P48 The limited yield of cultures in the critically ill child
title_sort p48 the limited yield of cultures in the critically ill child
topic Posters Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849361/
http://dx.doi.org/10.1093/jacamr/dlac004.047
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