QUANTITATION OF BACTEREMIA IN CHILDHOOD AND ITS RELATIONSHIP TO SEPTIC COMPLICATIONS

Abstract

The magnitude of bacteremia may be a primary determinant of whether children develop septic complications, such as meningitis. Therefore, quantitative blood cultures (QC) were sought in 243 febrile children from whom routine blood cultures (RC) were obtained because of unexplained fever. QC were obtained as follows; when blood was obtained for the RC, an additional 0.5 ml blood was drawn into a sterile syringe rinsed with polyanethol sulfonate; 10 and 100μl was plated directly on to 1)sheep blood agar and 2)brain-heart infusion media enriched with Levinthal base. There were 14 positive QC from 12 patients. These were 7 Hemophilus influenzae b, 5 S.pneunoniae and 2 S. aureus. Bacterial counts ranged from 20→10⁴ per ml. in three cases of H.Influenzae b meningitis, bacteremia exceeded 10³ organisms/ml. In nine other patients with bacteremia unassociated with meningitis, counts were 10²-10³/ml in three (pneumonia, peritonitis, isolated bacteremia) and <10²/ml in six (one pneumonia, one epiglottitis, four isolated bacteremia). Bacteremia detected by QC was identified as early or earlier than its recognition by RC. In three patients, bacteremia was detected by QC but not by RC. Quantitative cultures aided in the early detection of bacteremia and provided data that may help in identifying those children at highest risk for developing septic complications such as meningitis.

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