TY - JOUR
T1 - Evaluating blood culture collection practice in children hospitalized with acute illness at a tertiary hospital in Malawi
AU - Mukhula, Victoria Temwanani
AU - Harawa, Philliness Prisca
AU - Phiri, Chisomo
AU - Khoswe, Stanley
AU - Mbale, Emmie
AU - Tigoi, Caroline
AU - Walson, Judd L.
AU - Berkley, James A.
AU - Bandsma, Robert
AU - Iroh Tam, Pui-Ying
AU - Voskuijl, Wieger
PY - 2023/12/6
Y1 - 2023/12/6
N2 - BackgroundBlood culture collection practice in low-resource settings where routine blood culture collection is available has not been previously described.MethodologyWe conducted a secondary descriptive analysis of children aged 2-23 months enrolled in the Malawi Childhood Acute Illness and Nutrition (CHAIN) study, stratified by whether an admission blood culture had been undertaken and by nutritional status. Chi-square test was used to compare the differences between groups.ResultsA total of 347 children were included, of whom 161 (46%) had a blood culture collected. Children who had a blood culture collected, compared to those who did not, were more likely to present with sepsis (43% vs. 20%, p<0.001), gastroenteritis (43% vs. 26%, p<0.001), fever (86% vs. 73%, p=0.004), and with poor feeding/weight loss (30% vs. 18%, p=0.008). In addition, hospital stay in those who had a blood culture was, on average, 2 days longer (p=0.019). No difference in mortality was observed between those who did or did not have a blood culture obtained.ConclusionBlood culture collection was more frequent in children with sepsis and gastroenteritis, but was not associated with mortality. In low-resource settings, developing criteria for blood culture based on risk factors rather than clinician judgement may better utilise the existing resources.
AB - BackgroundBlood culture collection practice in low-resource settings where routine blood culture collection is available has not been previously described.MethodologyWe conducted a secondary descriptive analysis of children aged 2-23 months enrolled in the Malawi Childhood Acute Illness and Nutrition (CHAIN) study, stratified by whether an admission blood culture had been undertaken and by nutritional status. Chi-square test was used to compare the differences between groups.ResultsA total of 347 children were included, of whom 161 (46%) had a blood culture collected. Children who had a blood culture collected, compared to those who did not, were more likely to present with sepsis (43% vs. 20%, p<0.001), gastroenteritis (43% vs. 26%, p<0.001), fever (86% vs. 73%, p=0.004), and with poor feeding/weight loss (30% vs. 18%, p=0.008). In addition, hospital stay in those who had a blood culture was, on average, 2 days longer (p=0.019). No difference in mortality was observed between those who did or did not have a blood culture obtained.ConclusionBlood culture collection was more frequent in children with sepsis and gastroenteritis, but was not associated with mortality. In low-resource settings, developing criteria for blood culture based on risk factors rather than clinician judgement may better utilise the existing resources.
KW - antimicrobial resistance
KW - blood culture
KW - bloodstream infection
KW - children
KW - malnutrition
U2 - 10.1093/tropej/fmad043
DO - 10.1093/tropej/fmad043
M3 - Article
SN - 0142-6338
VL - 70
SP - fmad043
JO - Journal of Tropical Pediatrics
JF - Journal of Tropical Pediatrics
IS - 1
M1 - fmad043
ER -