title: Assessment of anaerobic blood cultures in pediatric oncology patients.
abstract: BACKGROUND
  The routine use of a single aerobic bottle for blood culture in pediatric patients has become commonplace, as anaerobic bacteria are not frequently involved in clinically significant infections. The aim of this study was to assess the usefulness of routinely performing anaerobic blood cultures in pediatric oncology patients.
  
  
  METHODS
  Prospective study was conducted on pediatric (<18 years) patients affected with febrile syndrome after receiving chemotherapy for hematological or solid malignancies. Samples were inoculated into pediatric aerobic and standard anaerobic bottles (BacT/Alert automatic system). Strains were considered clinically significant, or deemed as contaminants, depending on isolation circumstances and clinical criteria.
  
  
  RESULTS
  A total of 876 blood cultures from 228 patients were processed during the 21-month study period (January 2014 to September 2015). Baseline diagnosis included 143 solid tumors and 67/18 cases of leukemia/lymphoma. Bacterial growth was detected in 90 (10.2%) blood cultures for 95 different isolates, of which 62 (7.1%)/63 isolates were considered clinically significant. Among the latter, 38 (60.3%) microorganisms grew in both aerobic and anaerobic bottles, 18 (28.6%) only in aerobic bottles, and 7 (11.1%) only in anaerobic bottles. Gram-negative bacilli (33; 52.4%), mainly from the Enterobacteriaceae family, were the most frequently isolated microorganisms. Overall, only 3 out of 90 isolates (3.3%) were strict anaerobes (Propionibacterium acnes), and all of them were deemed contaminants.
  
  
  CONCLUSIONS
  Strict anaerobes did not cause significant infections in febrile pediatric oncology patients, and anaerobic blood culture bottles offered no additional advantages over aerobic media. Our results suggest that routine blood cultures should be solely processed in aerobic media in this group of patients.
authors.affiliation: Department of Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monsonís Cabedo
authors.affiliation: Department of Haematology and Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Rives Solá
authors.affiliation: Infectious Diseases Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
authors.affiliation: Infections Control Unit, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Urrea Ayala
authors.affiliation: Department of Haematology and Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
authors.forename: Ofelia
authors.initials: O
authors.lastname: Cruz Martinez
authors.affiliation: Department of Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain. Electronic address: agene@hsjdbcn.org.
authors.forename: Amadeu
authors.initials: A
authors.lastname: Gené Giralt
mesh_terms: D000293:Adolescent; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D000071997:Blood Culture; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000382:microbiology*; D011446:Prospective Studies
keywords: Anaerobic; Anaerobio; Bacteraemia; Bacteriemia; Blood culture; Hemocultivo; Oncology; Oncología; Pediatric; Pediatría