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Timing of positive blood samples does not differentiate pathogens causing healthcare-associated from community-acquired bloodstream infections in children in England: Linked retrospective cohort study

Henderson, KL; Muller-Pebody, B; Wade, A; Sharland, M; Minaji, M; Johnson, A; Gilbert, R; (2015) Timing of positive blood samples does not differentiate pathogens causing healthcare-associated from community-acquired bloodstream infections in children in England: Linked retrospective cohort study. Epidemiology and Infection , 143 (11) pp. 2440-2445. 10.1017/S0950268814003306. Green open access

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Abstract

Paediatricians recognize that using the time-dependant community-acquired versus hospital-acquired bloodstream infection (BSI) dichotomy to guide empiric treatment no longer distinguishes between causative pathogens due to the emergence of healthcare-associated BSI. However, paediatric epidemiological evidence of the aetiology of BSI in relation to hospital-admission in England is lacking. For 12 common BSI-causing pathogens in England, timing of laboratory reports of positive paediatric (3 months-5 years) bacterial blood isolates were linked to in-patient hospital data and plotted in relation to hospital-admission. The majority of linked pathogens (88.6%) were isolated <2 days after hospital admission, including pathogens widely regarded as hospital-acquired: Enterococcus spp. (67.2%)and Klebsiella spp. (88.9%). Neisseria meningitidis, Streptococcus pneumoniae, group A streptococcus and Salmonella spp. were unlikely to cause hospital-acquired BSI. Pathogens commonly associated with hospital-acquired BSI are being isolated <2 days after hospital admission alongside pathogens commonly associated with community-acquired BSI. We confirm that timing of blood samples alone does not differentiate between bacterial pathogens. Additional factors including clinical patient characteristics and healthcare-contact should be considered to help predict the causative pathogen and guide empiric antibiotic therapy.

Type: Article
Title: Timing of positive blood samples does not differentiate pathogens causing healthcare-associated from community-acquired bloodstream infections in children in England: Linked retrospective cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0950268814003306
Publisher version: http://dx.doi.org/10.1017/S0950268814003306
Language: English
Additional information: Copyright © Cambridge University Press 2014 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Bloodstream infections, hospital-acquired (nosocomial) infections, microbiology, paediatrics
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1456311
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