scholarly journals Comparative Study of Three Different BACTEC Culture Media for the Detection of Bacteremia in Ambulatory and Hospitalized Children

1998 ◽  
Vol 9 (2) ◽  
pp. 77-82 ◽  
Author(s):  
Deirdre L Church ◽  
H Dele Davies ◽  
G Cadrain ◽  
Cynthia L Trevenen
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Culture Media ◽  
Optimal Recovery ◽  
Pediatric Care ◽  
Hospitalized Children ◽  
Anaerobic Bottle ◽  
The Common ◽  
Clinically Significant ◽  
Group D

To compare the yield of two aerobic and an anaerobic BACTEC blood culture media in detecting bacteremia in ambulatory and hospitalized care settings at a children’s hospital, a prospective cohort study was completed. Over an 18-month period, equal blood volumes (minimum of 1 mL/bottle) were inoculated into a three-bottle culture set including aerobic BACTEC NR 6A, aerobic BACTEC PEDS Plus and anaerobic NR 7A broths. Chart reviews were completed on all children with bacteremia to determine whether the isolate was clinically significant based on predefined criteria. Among 5328 evaluable blood culture sets, 323 clinically significant organisms (110 from ambulatory and 213 from hospitalized children) were isolated. MostStreptococcus pneumoniae,Haemophilusspecies, andNeisseriaorMoraxellaspecies were recovered from children attending the emergency department or out-patient clinics. Important isolates in hospitalized children included most of the staphylococci andEnterobacteriaceae, and all group D enterococci, Gram-negative nonfermentative bacilli and allCandidaspecies. Overall, significantly more isolates were detected only in the anaerobic bottle from ambulatory children (P<0.0001), including 13 of 54 (24%) patients withS pneumoniaebacteremias presenting to the emergency department. This study indicated that different BACTEC blood culture media combinations are needed in ambulatory and hospitalized pediatric care settings to ensure the optimal recovery of all types of isolates. Whereas aerobic blood culture bottles are adequate for detection of bacteremia in hospitalized children, the common occurrence of fastidious organisms mandates the need for a combined aerobic/anaerobic culture set in ambulatory pediatric care settings.

scholarly journals The Addition of Anaerobic Blood Cultures for Pediatric Patients with Concerns for Bloodstream Infections: Prevalence and Time to Positive Cultures

2020 ◽  
Vol 58 (9) ◽  
Author(s):  
Jennifer Dien Bard ◽  
Todd P. Chang ◽  
Rebecca Yee ◽  
Keya Manshadi ◽  
Nhan Lichtenfeld ◽  
...  
Keyword(s):  
Blood Culture ◽  
Pediatric Patients ◽  
Bloodstream Infections ◽  
Pediatric Emergency ◽  
Blood Cultures ◽  
Secondary Outcome ◽  
Culture Positivity ◽  
Blood Culture Positivity ◽  
Anaerobic Bottle ◽  
Clinically Significant

ABSTRACT Anaerobes are an important but uncommon cause of bloodstream infections (BSIs). For pediatric patients, routine inclusion of an anaerobic blood culture alongside the aerobic remains controversial. We implemented automatic anaerobic blood culture alongside aerobic blood cultures in a pediatric emergency department (ED) and sought to determine changes in recovery of obligate and facultative anaerobes. This was a cohort study in a pediatric ED (August 2015 to July 2018) that began in February 2017. Blood culture positivity results for true pathogens and contaminants were assessed, along with a secondary outcome of time to positivity (TTP) of blood culture. A total of 14,180 blood cultures (5,202 preimplementation and 8,978 postimplementation) were collected, with 8.8% (456) and 7.1% (635) positive cultures in the pre- and postimplementation phases, respectively. Of 635 positive cultures in the postimplementation phase, aerobic blood cultures recovered 7.6% (349/4,615), whereas anaerobic blood cultures recovered 6.6% (286/4,363). In 211/421 (50.0%) paired blood cultures, an organism was recovered in both cultures. The number of cases where organisms were only recovered from an aerobic or an anaerobic bottle in the paired cultures were 126 (30.0%) and 84 (20.0%), respectively. The TTP was comparable regardless of bottle type. Recovery of true pathogens from blood cultures was approximately 7 h faster than recovery of contaminants. Although inclusion of anaerobic blood cultures only recovered 2 (0.69%) obligate anaerobes, it did allow for recovery of clinically significant pathogens that were negative in aerobic blood cultures and supports the routine collection of both bottles in pediatric patients with a concern of bloodstream infections.

Recovery of Haemophilus influenzae from twenty-three blood culture media

1979 ◽  
Vol 9 (1) ◽  
pp. 84-87
Author(s):  
R F Schell ◽  
J L Le Frock ◽  
J P Babu ◽  
D B Robinson
Keyword(s):  
Blood Culture ◽  
Haemophilus Influenzae ◽  
Culture Medium ◽  
Culture Media ◽  
Optimal Recovery ◽  
Becton Dickinson ◽  
Recovery Rates ◽  
Growth Requirements

Haemophilus influenzae is an important agent of bacteremia and has fastidious growth requirements. The purpose of this investigation was to determine the ability of commercial blood culture media to support the growth of this fastidious microorganism. Twenty-three types of blood culture media were inoculated with individual suspensions of eight strains of H. influenzae in the presence or absence of an erythrocyte-serum mixture. The rates of recovery of the H. influenzae strains from the various types of blood culture media were compared. The results demonstrated that the type of medium, the manufacturer, the erythrocyte-serum mixture, and the strain of H. influenzae influenced the recovery rates of H. influenzae. Optimal recovery of the strains of H. influenzae was obtained from brain heart infustion blood culture medium (GIBCO). Trypic soy broth (GIBCO) and supplemental peptone of Becton, Dickinson and Co. also were found to be superior to the remaining types of media tested for the recovery of H. influenzae.

scholarly journals A COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND MIDAZOLAM AS AN ADJUVANT TO INTRATHECAL BUPIVACAINE

2020 ◽  
pp. 1-4
Author(s):  
K.K. Arora ◽  
Neetu Gupta ◽  
Nidhi Sharma
Keyword(s):  
Side Effect ◽  
Motor Block ◽  
Local Anaesthetics ◽  
Efficacy And Safety ◽  
Significant Side Effect ◽  
Significant Difference ◽  
Haemodynamic Changes ◽  
The Common ◽  
Clinically Significant ◽  
Group D

Background: Subarachnoid block(SAB) is the common mode of anaesthesia. To prolong its action various adjuvants are being added to local anaesthetics(LA). In this study we compared the efficacy and safety of midazolam and dexmedetomidine as an adjuvant to intrathecal 0.5% hyperbaric (H) bupivacaine. Material & Methods: 80 ASA grade I or II patients of either sex scheduled for lower limb or lower abdominal surgeries were randomly allocated into two groups, Group D & Group M. In group D, patients received 3ml of 0.5% (H) bupivacaine + dexmedetomidine 5mcg in 0.5ml normal saline(NS). While group M received 3ml of 0.5% (H) bupivacaine + 2mg midazolam ( 0.4ml of 5mg/ml) + 0.1ml of NS. Onset of sensory & motor block and duration of sensory & motor block were recorded. Patients were monitored for any haemodynamic changes and side effect. Result: Duration of both sensory & motor blockade was significantly prolonged in group D as compared to group M. There was no clinically significant difference observed among both the groups in respect to hemodynamic parameters, sedation and side effect. Conclusion: Dexmedetomidine as an adjuvant to intrathecal bupivacaine (H) was better as compared to midazolam. It significantly prolongs the duration of analgesia postoperatively without any significant side effect.

Quick Looks Into the Acute Abdomen- Findings from A 1 Year Audit of Asian Emergency Department Ct Scans

2021 ◽  
Author(s):  
Siang Hiong Goh ◽  
Calvin Yit-Kun Goh ◽  
Hong Choon Oh ◽  
Narayan Venkataraman ◽  
Ling Tiah
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Clinical Performance ◽  
Biliary Tract Disease ◽  
Renal Stones ◽  
Adverse Outcomes ◽  
Ct Scans ◽  
Lower Quadrant ◽  
Lengths Of Stay ◽  
The Common

Abstract BackgroundMuch of the literature regarding Emergency Department CT scan usage for abdominal pain has been in American and European settings, and less so in the rest of the world. We performed an audit for this in our Southeast Asian hospital to see how we compare with international data, also to glean some insights into optimising its use locally.Results – An anonymised de-identified electronic database of all ED patients had been set up since 2020 with the aim of capturing 10 years of ED retrospective data for audit of our clinical performance. From this master database, a subset of all CTAPs done in 2020 was created and then extracted for analysis. Costs, length of stay in the ED and wards, CT reports, disposal from ED, and other data were captured for study. A description was made of the common conditions found, with a subgroup analysis of the elderly, and disposal outcomes from the ED. Specific analysis was done for appendicitis using Mann-Whitney U tests. For 2020, 1860 patients (56% male, and ages 14 to 99 years) had ED CTAPs done. Top indications included right upper and lower quadrant pains, flank pains, persistent abdominal pain despite analgesia, and suspicion for intestinal obstruction. Acute appendicitis, biliary tract disease, renal stones, ovarian disease, and bowel disease were the common diagnoses. 16.2% of CTAPs revealed no abnormality. Malignancies were uncommon diagnoses. For the patients that were discharged from the ED after a negative CTAP, no patient returned within 72 hours nor were there any adverse outcomes. When analysed using Mann-Whitney U tests, patients who had ED CTAPs done for appendicitis had significantly faster time to CT and surgery than those with inpatient imaging, with lower inpatient costs and lengths of stay.Conclusion – CT scans in the ED for appendicitis patients reduces costs, time to surgery, and lengths of stay. Generally, ED CTAPs allows better siting and disposition of patients. Presence of RLQ pain increases the likelihood of a positive scan. Our negative scan rate of 16.2% is comparable to other studies. Protocols and senior inputs can improve accuracy of this important ED resource.

Enhancing Patient Compliance in Pediatrics

1996 ◽  
Vol 17 (4) ◽  
pp. 128-134
Author(s):  
Gregory S. Liptak
Keyword(s):  
Emergency Department ◽  
Medical Education ◽  
Rheumatic Fever ◽  
Acute Otitis Media ◽  
Streptococcal Pharyngitis ◽  
Pediatric Care ◽  
Pediatric Residency ◽  
Health Advice ◽  
Advanced Treatments

The Challenge Pediatric care has become exceedingly complex, but no matter how technologically advanced treatments become, they can be only as effective as compliance with their use. Compliance, or adherence, defined as the extent to which a person's behavior coincides with medical or health advice, is crucial for the treatment of illness, the prevention of disease, and the promotion of health. Unfortunately, noncompliance is extremely common. For example, in a study of the use of penicillin for acute otitis media and "strep" throat, Charney et al1 found that only 43% of the children complied with the regimen. Gordis and associates2 found that compliance with penicillin used for chronic rheumatic fever prophylaxis was only 36%. Eney and Goldstein3 showed that compliance with theophylline in children being evaluated in an emergency department for asthma was only 11%. Compliance decreases over the course of treatment, not only for long-term interventions, but for brief ones as well. For example, Bergman and Werner4 found that 56% of individuals being treated with penicillin for streptococcal pharyngitis had stopped taking the medication by day 3, 71% by day 6, and 82% by day 9 of the treatment course. Although compliance is so important, it is largely neglected in medical education, including pediatric residency training.

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