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American Academy of Pediatrics
Article

Blood Cultures in the Evaluation of Uncomplicated Skin and Soft Tissue Infections

Jay R. Malone, Sarah R. Durica, David M. Thompson, Amanda Bogie and Monique Naifeh
Pediatrics September 2013, 132 (3) 454-459; DOI: https://doi.org/10.1542/peds.2013-1384
Jay R. Malone
Sections of aGeneral and Community Pediatrics and
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Sarah R. Durica
bThe University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
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David M. Thompson
Sections of aGeneral and Community Pediatrics and
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Amanda Bogie
cEmergency Medicine, Department of Pediatrics, The University of Oklahoma, Oklahoma City, Oklahoma; and
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Monique Naifeh
Sections of aGeneral and Community Pediatrics and
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Abstract

BACKGROUND: Blood cultures are often obtained in children hospitalized with skin and soft tissue infections (SSTIs). Because little evidence exists to validate this practice, we examined the yield of blood cultures in the evaluation of immunocompetent children with SSTIs.

METHODS: Medical records were reviewed for all children admitted between January 1, 2007 and December 31, 2009 after emergency department evaluation and diagnosis of cellulitis or abscess. We compared patients with SSTIs (n = 482) with those with complicated SSTIs (cSSTIs; n = 98). A cSSTI was defined as surgical or traumatic wound infection, need for surgical intervention, or infected ulcers or burns. The SSTI group included patients without complicating factors.

RESULTS: None of the patients in the SSTI group had a positive blood culture. In the cSSTI group, 12.5% of blood cultures were positive. The mean length of hospital stay (LOHS) of children with SSTIs was shorter than that of those with cSSTIs (P < .001). In the SSTI group, obtaining a blood culture was associated with a higher mean LOHS (P = .044).

CONCLUSIONS: Blood cultures are not useful in evaluating immunocompetent children who are admitted to the hospital with uncomplicated SSTIs, and they are associated with a nearly 1-day increase in mean LOHS.

  • abscess
  • cellulitis
  • bacteremia
  • infant
  • child
  • adolescent
  • blood
  • culture
  • blood specimen collection
  • Abbreviations:
    CA-MRSA —
    community-acquired methicillin-resistant Staphylococcus aureus
    CI —
    confidence interval
    CRP —
    C-reactive protein
    cSSTI —
    complicated skin and soft tissue infection
    ED —
    emergency department
    LOHS —
    length of hospital stay
    MRSA —
    methicillin-resistant Staphylococcus aureus
    SSTI —
    skin and soft tissue infection
    WBC —
    white blood cell
    • Accepted June 20, 2013.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 132, Issue 3
    1 Sep 2013
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    Blood Cultures in the Evaluation of Uncomplicated Skin and Soft Tissue Infections
    Jay R. Malone, Sarah R. Durica, David M. Thompson, Amanda Bogie, Monique Naifeh
    Pediatrics Sep 2013, 132 (3) 454-459; DOI: 10.1542/peds.2013-1384

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    Blood Cultures in the Evaluation of Uncomplicated Skin and Soft Tissue Infections
    Jay R. Malone, Sarah R. Durica, David M. Thompson, Amanda Bogie, Monique Naifeh
    Pediatrics Sep 2013, 132 (3) 454-459; DOI: 10.1542/peds.2013-1384
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    Keywords

    • abscess
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