Evaluating blood culture collection practice in children hospitalized with acute illness at a tertiary hospital in Malawi

Temwanani Mukhula, Victoria, Prisca Harawa, Philliness, Phiri, Chisomo, Khoswe, Stanley, Mbale, Emmie, Tigoi, Caroline, Walson, Judd, Berkley, James, Bandsma, Robert, Iroh Tam, Pui-Ying ORCID: https://orcid.org/0000-0002-3682-8892 and Voskuijl, Wieger (2023) 'Evaluating blood culture collection practice in children hospitalized with acute illness at a tertiary hospital in Malawi'. Journal of Tropical Pediatrics, Vol 70, Issue 1, fmad043.

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Abstract

Background
Blood culture collection practice in low-resource settings where routine blood culture collection is available has not been previously described.

Methodology
We conducted a secondary descriptive analysis of children aged 2-23 months enrolled in the Malawi Childhood Acute Illness and Nutrition (CHAIN) study, stratified by whether an admission blood culture had been undertaken and by nutritional status. Chi-square test was used to compare the differences between groups.

Results
A total of 347 children were included, of whom 161 (46%) had a blood culture collected. Children who had a blood culture collected, compared to those who did not, were more likely to present with sepsis (43% vs. 20%, p<0.001), gastroenteritis (43% vs. 26%, p<0.001), fever (86% vs. 73%, p=0.004), and with poor feeding/weight loss (30% vs. 18%, p=0.008). In addition, hospital stay in those who had a blood culture was, on average, 2 days longer (p=0.019). No difference in mortality was observed between those who did or did not have a blood culture obtained.

Conclusion
Blood culture collection was more frequent in children with sepsis and gastroenteritis, but was not associated with mortality. In low-resource settings, developing criteria for blood culture based on risk factors rather than clinician judgement may better utilise the existing resources.

Item Type:	Article
Subjects:	QY Clinical Pathology > Blood. Blood Chemistry > QY 450 Blood chemistry WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 115 Nutritional requirements. Nutrition disorders WS Pediatrics > By Age Groups > WS 430 Infancy WS Pediatrics > By Age Groups > WS 440 Preschool child
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI):	https://doi.org/10.1093/tropej/fmad043
Depositing User:	Amy Carroll
Date Deposited:	31 Oct 2023 11:39
Last Modified:	04 Mar 2024 14:32
URI:	https://archive.lstmed.ac.uk/id/eprint/23388

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