Blood Culture in Evaluation of Pediatric Community-Acquired Pneumonia: A Systematic Review and Meta-analysis.

@article{IrohTam2015BloodCI,
  title={Blood Culture in Evaluation of Pediatric Community-Acquired Pneumonia: A Systematic Review and Meta-analysis.},
  author={Pui-Ying Iroh Tam and Ethan M Bernstein and Xiaoye Ma and Patricia Ferrieri},
  journal={Hospital pediatrics},
  year={2015},
  volume={5 6},
  pages={
          324-36
        }
}
BACKGROUND AND OBJECTIVE Current guidelines strongly recommend collection of blood cultures (BCs) in children requiring hospitalization for presumed moderate to severe bacterial community-acquired pneumonia (CAP). Our objective was to systematically review the international pediatric literature to evaluate how often BCs are positive in hospitalized children with CAP, identify the most commonly isolated pathogens, and determine the impact of positive BCs on clinical management. METHODS We… 
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Value of Blood Cultures in the Management of Children Hospitalized with Community-Acquired Pneumonia
TLDR
The prevalence of bacteremia among children admitted for CAP is low and the use of routine blood cultures should be reserved for children with moderate to severe pneumonia.
Low utility of blood culture in pediatric community-acquired pneumonia: An observational study on 2705 patients admitted to the emergency department
TLDR
A low utility of blood cultures is confirmed in previously healthy children and adolescents with community-acquired pneumonia who were admitted to the ED and the need to refine the current guidelines for obtaining blood cultures in the ED for pediatric CAP is suggested.
Utility of Blood Culture Among Children Hospitalized With Community-Acquired Pneumonia
TLDR
Among children without comorbidities hospitalized with CAP in a non-ICU setting, the rate of bacteremia was low, and isolated pathogens were usually susceptible to penicillin.
Diagnosis of Community-acquired Pneumonia in Hospitalized Children: A Multicenter Experience in Bolivia
TLDR
The higher prevalence of RSV, influenza, and Streptococcus pneumoniae reveals the need for preventive measures with better vaccine uptake and future research for RSV vaccines and RT-PCR provided additional diagnostic value to conventional, clinical, and laboratory methods.
PREVALENCE AND PREDICTORS OF BACTEREMIA AMONG CHILDREN HOSPITALIZED WITH PNEUMONIA.
TLDR
This study shows that hemoculture do not need to be routinely performed in all children hospitalized with community-acquired pneumonia in Thailand, and there were 3 clinical and 2 laboratory factors significantly associated with bacteremia.
Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children
TLDR
Bacteremia was uncommonly detected in this large multicenter cohort of children hospitalized with community-acquired pneumonia but was associated with severe disease.
How often are blood cultures positive and change management in pediatric patients hospitalized with community acquired pneumonia?
TLDR
Blood cultures drawn in pediatric patients hospitalized for community-acquired pneumonia are positive two to five percent of the time and perhaps up to 10% of thetime in patients with severe pneumonia, and drawing cultures is unlikely to change management.
A meta-analysis of antimicrobial susceptibility profiles for pneumococcal pneumonia in sub-Saharan Africa
TLDR
The establishment of national and regional diagnostic platforms to monitor antimicrobial susceptibility profiles for pneumonia as well as other invasive diseases will provide data with which to assess the relevance and adaptation of antimicrobial prescribing recommendations.
Recent Developments in Pediatric Community-Acquired Pneumonia
TLDR
This review focuses on several key areas relevant to the clinical management of CAP, including the role of vaccination in the prevention of pediatric CAP and the expanding role of existing and emerging diagnostic technologies in CAP classification and management.
Factors Associated With Pneumonia Severity in Children: A Systematic Review.
TLDR
A systematic review summarizes the current state of the evidence for defining and predicting pneumonia severity in children as well as emerging evidence focused on risk stratification of children with pneumonia.
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References

SHOWING 1-10 OF 61 REFERENCES
Blood cultures for community-acquired pneumonia: are they worthy of two quality measures? A systematic review.
TLDR
BCs have very limited utility in immunocompetent patients hospitalized with CAP and Pneumonia quality measures that include BCs should be reassessed.
The prevalence of bacteremia in pediatric patients with community-acquired pneumonia: guidelines to reduce the frequency of obtaining blood cultures.
TLDR
It is suggested that blood cultures may not need to be routinely obtained in all patients admitted to the hospital with CAP, and local guidelines that limit the frequency of obtaining blood cultures in pediatric patients with CAP are likely to capture any patient with bacteremia.
Prevalence of Bacteremia in Hospitalized Pediatric Patients With Community-acquired Pneumonia
TLDR
The prevalence of bacteremia was higher than previously reported in children hospitalized with CAP and consistent across children’s hospitals, and positive blood cultures should prompt change to narrow-spectrum antibiotic therapy.
Spectrum of pathogens of in-patient children and youths with community acquired pneumonia: a 3 year survey of a community hospital in Vienna, Austria
TLDR
Testing for pathogens in CAP in clinical routine achieves a high recovery rate, but the molecular testing for viruses seemed to be helpful to establish the diagnosis, and c-reactive protein was significantly higher in children with positive Streptococcus pneumoniae antigen than with viral infection and/or co-infection.
Usefulness of initial blood cultures in patients admitted with pneumonia from an emergency department in Japan
TLDR
It is found that blood cultures could identify organisms in only a few patients with pneumonia and rarely altered antibiotic management even in patients with positive cultures, so it may not be necessary to obtain blood cultures for patients admitted with pneumonia.
Selective use of blood cultures in emergency department pneumonia patients.
Utility of blood cultures in pediatric patients found to have pneumonia in the emergency department.
Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children.
TLDR
The data confirm the importance of S pneumoniae and the frequent occurrence of bacterial and viral coinfections in children with pneumonia and will facilitate age-appropriate antibiotic selection and future evaluation of the clinical effectiveness of the pneumococcal conjugate vaccine as well as other candidate vaccines.
Utility of blood cultures in the management of adults with community acquired pneumonia discharged from the emergency department
TLDR
BCs have little utility in the ambulatory management of CAP, and the courses of antibiotic regimens and outcomes of patients with positive BC results were examined to assess their influence on BCs.
Etiology of community‐acquired pneumonia in 254 hospitalized children
TLDR
The possible causative agent of childhood community‐acquired pneumonia can be detected in most cases and with effective immunization for S. pneumoniae and respiratory syncytial virus infections, more than one‐half of the pneumonia cases in this study could have been prevented.
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