Diagnosis of Bloodstream Infections in Children

Abstract

Identification of bloodstream infections is among the most critical tasks performed by the clinical microbiology laboratory. While the criteria for achieving an adequate blood culture specimen in adults have been well described, there is much more ambiguity in pediatric populations. This minireview focuses on the available pediatric literature pertaining to the collection of an optimal blood culture specimen, including timing, volume, and bottle selection, as well as rapid diagnostic approaches and their role in the management of pediatric bloodstream infections.

FIG 1

There is no consensus on blood volume collection recommendations by weight. Modified with permission from Lancaster et al. (34). Summary of recommended blood volume by Cumitech 1C blood cultures IV, the Infectious Diseases Society of America (IDSA) and the American Society of Microbiology (ASM), the Manual of Clinical Microbiology, 10th ed, and the Clinical and Laboratory Standards Institute (CLSI) guideline M47-A. An estimated total blood volume of 80 kg/ml was used to illustrate CLSI's recommendation of not exceeding 1% of total blood volume.