• Itai Gross, Oren Gordon, Wiessam Abu Ahmad, Shmuel Benenson, Ben Simon Piatkowski, Smadar Eventov-Friedman, and Saar Hashavya.
• From the Department of Pediatrics, School of Public Health and Community Medicine, Hadassah and The Hebrew University Medical Center, Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hadassah and The Hebrew University Medical Center, Department of Neonatology, and Department of Pediatric Emergency Medicine, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel.
• Pediatr. Infect. Dis. J. 2018 Apr 1; 37 (4): 281-286.

BackgroundAnaerobic bacteremia is rare in children and current recommendations advocate against the routine use of anaerobic cultures in children. However, the incidence of anaerobic bacteremia and the utility of anaerobic blood cultures in children have not been assessed in recent years. Our pediatric emergency department (PED) policy still supports the use of both aerobic and anaerobic blood cultures in all cases of suspected bacteremia. This allowed us to re-evaluate the yield of anaerobic cultures in PED settings.MethodsRetrospective data of all blood cultures taken in the PED in a single tertiary center from 2002 to 2016 were collected. The incidence and characteristics of children with positive anaerobic blood cultures were assessed. Risk factors for anaerobic bacteremia were defined.ResultsOf the 68,304 blood culture sets taken during the study period, 971 (1.42%) clinically significant positive cultures were found. Pathogenic obligatory anaerobic bacteria were isolated in 33 (0.05%) cultures. The leading risk factors for anaerobic bacteremia were head and neck abscess and intra-abdominal infection. Of all the true positive cultures, 187 (22%) were only detected in the anaerobic culture and would have otherwise been missed.ConclusionsTrue anaerobic bacteremia is extremely rare in children admitted to the PED. Nevertheless, using anaerobic cultures may increase the overall yield of blood cultures.

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