Role of Anaerobic Blood Cultures in Neonatal Bacteremia
Role of Anaerobic Blood Cultures in Neonatal Bacteremia
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DOI：
10.1093/jpids/pix088
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发表时间：
2018-09-01
影响因子：
3.2
通讯作者：
Neemann, Kari
中科院分区：
文献类型：
--
作者：
Messbarger, Nathan;Neemann, Kari
背景新生儿败血症的评估通常包括进行需氧和厌氧血培养，尽管我们缺乏对该年龄组厌氧菌血症的真实发生率以及不进行这些配对培养的后果的了解。我们对一家儿童医院所有新生儿的血培养进行了回顾性分析。具有临床意义的病原体定义为很少被认为是污染物的微生物，从多个血液培养物或部位回收，或根据患者的主治医生认为具有重要意义。对每例培养结果阳性的患者的病历进行回顾，以了解患者的特征。在2013年11月1日至2015年4月30日期间，共从403名患者中获得了662个培养集。从25例患者的64（9.7%）个培养组中分离出具有临床意义的微生物（污染率为1.9%）。共分离出56种微生物; 35种（62.5%）在需氧和厌氧培养瓶中均生长，19种（33.9%）仅在厌氧培养瓶中生长，2种（3.6%）仅在需氧培养瓶中生长。鉴定出1株（0.2%）专性厌氧菌（共生梭菌）。虽然新生儿厌氧菌血症的发生率很低，但鉴于从厌氧血培养瓶中分离的需氧和兼性厌氧微生物的产量增加，厌氧培养在这一人群中仍然很重要。
Background. Evaluation for neonatal sepsis routinely includes performing both aerobic and anaerobic blood cultures despite our lack of knowledge of the true incidence of anaerobic bacteremia in this age group and the consequences of not performing these paired cultures.Methods. We performed a retrospective review of all blood cultures performed for neonates in a children's hospital. Clinically significant pathogens were defined as microorganisms that rarely are considered to be contaminants, that were recovered from multiple blood cultures or sites, or were considered significant according to the patient's attending physician. The chart of every patient with positive culture results was reviewed for patient characteristics.Results. A total of 662 culture sets among 403 patients were obtained between November 1, 2013, and April 30, 2015. A clinically significant organism was isolated from 64 (9.7%) culture sets from 25 patients (1.9% contamination rate). A total of 56 organisms were isolated; 35 (62.5%) grew from both the aerobic and anaerobic bottles, 19 (33.9%) grew from the anaerobic bottle alone, and 2 (3.6%) grew from the aerobic bottle alone. One (0.2%) obligate anaerobic bacterium (Clostridium symbiosum) was identified.Conclusions. Although the incidence of anaerobic bacteremia in neonates is rare, anaerobic culture remains important in this population, given the increased yield of both aerobic and facultative anaerobic organisms isolated from anaerobic blood culture bottles.