A retrospective study of factors which determine a negative blood culture in Cambodian children diagnosed with enteric fever

Paediatr Int Child Health. 2016 May;36(2):118-21. doi: 10.1179/2046905515Y.0000000009.

Abstract

Background: Blood cultures are used to confirm a diagnosis of enteric fever but reported sensitivities can be as low as 40%.

Aims: To determine the factors associated with a negative blood culture in Cambodian children with suspected enteric fever.

Methods: In a retrospective study of hospitalised Cambodian children given a discharge diagnosis of enteric fever, the following factors associated with a negative blood culture were analysed: age, blood culture volume, prior antibiotic therapy, duration of illness and disease severity.

Results: In 227 hospitalised Cambodian children with a discharge diagnosis of enteric fever, it was confirmed in 70% by a positive blood culture. There was no association between a negative blood culture and younger age, lower blood volumes for culture, prior antibiotic therapy, a late presentation or milder disease.

Conclusions: Although blood culture sensitivity was higher than expected, alternative simple, rapid and sensitive tests are needed for diagnosing enteric fever.

Keywords: Angkor Hospital for Children; Blood culture; Cambodia; Children; Enteric fever; Paediatric; Salmonella; Typhoid.

MeSH terms

  • Bacteriological Techniques
  • Blood Culture / methods*
  • Cambodia
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Salmonella typhi / isolation & purification*
  • Sensitivity and Specificity
  • Typhoid Fever / blood
  • Typhoid Fever / diagnosis*