Introduction
Blood culture is crucial for diagnosing invasive diseases. The effect of antibiotic use before blood culture collection among children <5 years with suspected invasive diseases is unclear. We describe the effect of antibiotic activity on blood culture outcomes in children <5 years with suspected invasive pneumococcal diseases in rural Gambia.
Methods
Between 2019 and 2021, we collected blood cultures and whole blood at the pediatric outpatient departments of two hospitals from children <5 years old with suspected invasive diseases. Information on antibiotic use in the last week pre-hospital presentation was collected from parents/caregivers. Blood cultures were performed using standardized methods. Antimicrobial activity assay was performed on whole blood to test for the presence of antibiotics. Descriptive statistics and logistic regression analyses were performed.
Results
Of 1715 samples, blood culture positivity rate was 77(4.5%), and 95(5.5%) had positive antibiotic activity. Blood culture was positive in 9/95(9.5%) of patients with positive antibiotic activity compared to 68/1620(4.2%) in those with negative antibiotic activity. Antibiotic activity was detected in 34/420(8.1%) patients who had reported prior antibiotic use. Blood culture positivity rate was 25/420(6.0%) and 52/1295(4.0%) among those who reported and those who did not report prior antibiotic use respectively. Those with positive antibiotic activity were 2.4 times more likely to have a positive blood culture compared to those with no antibiotic activity (odds ratio, 2.40; 95%CI, 1.15-4.95; p=0.02).
Conclusions
In contrast to findings from similar studies, we found a positive correlation between positive antibiotic activity and blood culture positivity.