Background and Objectives: Bacteremia is diagnosed based on clinical suspicion and positive blood cultures. In the past it was a common practice to obtain both aerobic and anaerobic blood cultures from children presenting in the emergency department (ED) with suspected bacteremia, however few reports demonstrated a very low yield of anaerobic blood cultures in the pediatric population.
Our study assessed the yield of obtaining anaerobic blood cultures in the ED set up.
Methods: In this retrospective study, clinical and laboratory data of all children of whom blood cultures were taken in the ED in a single tertiary center from 2007 to 2015 was collected. The incidence and characteristics of children with positive anaerobic blood cultures was assessed.
Results: During the study period, 68304 blood cultures were drawn in the ER. Of these, 3349 were positive (4.9%). After reviewing the data, we show that only 33 (0.05% of all cultures; 0.99% of positive cultures) of these cultures represent pathogenic anaerobic bacteremia. Leading risk factors for true anaerobic bacteremia are acute abdomen and suspected abscess (mastoiditis, dental abscess, etc.).
Conclusion: True anaerobic bacteremia is extremely rare in low risk children. Using anaerobic blood cultures in the pediatric ER is not justified due to its extremely low yield and high cost. Moreover, omitting the use of anaerobic cultures may increase the volume of blood used for aerobic cultures, thus increasing its yield. In high risk children, both types of blood cultures should be used.
