Occult Bacteremia in the Postpneumococcal Vaccine Era: No More Blood Cultures

In a study of some 8000 previously healthy, young febrile children with no apparent source of infection, the rate of true-positive blood cultures was only 0.25%.

For decades, the work-up of febrile young children included blood cultures to rule out occult bacteremia. This study assessed the usefulness of this practice in the era of routine childhood immunization with pneumococcal vaccine. Researchers retrospectively reviewed the charts of 8408 previously healthy children (age range, 3–36 months) who presented to a pediatric emergency department in Phoenix between 2004 and 2007 with fever ≥39°C, had no apparent source of infection, had blood cultures drawn, and were discharged from the ED.

A pediatric infectious diseases specialist determined that 21 blood cultures were true positives (0.25%); of these, 14 grew Streptococcus pneumoniae. Another 159 positive cultures (1.89%) were determined to be conta…

Reviewing Author

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)

Occult Bacteremia in the Postpneumococcal Vaccine Era: No More Blood Cultures

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Reviewing Author