{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:16:17Z","timestamp":1792149377027,"version":"4.4.0"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Staphylococcus\u2008aureus is a common pathogen seen in pediatric bloodstream infections. Currently, no evidence-based recommendations are used to guide decisions on the number of follow-up blood cultures (FUBCs) needed to demonstrate infection clearance. Unnecessary cultures increase the risk of false-positives, add to health care costs, and create additional trauma to children and their families. In this study, we examined risk factors for persistent S aureus bacteremia (SAB) and intermittent positive blood cultures (positive cultures obtained after a documented negative FUBC result) to determine the number of FUBCs needed to demonstrate infection clearance in children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Patients \u226418 years who were hospitalized with SAB at Texas Children\u2019s Hospital in 2018 were reviewed. We assessed the impact of an infectious disease diagnosis (central line\u2013associated bloodstream infection, osteomyelitis, soft tissue infection, endocarditis, etc) and medical comorbidities on bacteremia duration. Patients with intermittent positive blood cultures were studied to determine the characteristics of this group and overall frequency of reversion to positive cultures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>A total of 122 subjects met the inclusion criteria. The median duration of bacteremia was 1 day (interquartile range: 1\u20132 days). Only 19 patients (16%) had bacteremia lasting \u22653 days, all of whom had a diagnosis of central line\u2013associated bloodstream infection, osteomyelitis, or endocarditis. Intermittent positive cultures occurred in 5% of patients, with positive cultures after 2 negative FUBC results seen in &amp;lt;1% of patients. Intermittent positive cultures were strongly associated with osteomyelitis and endocarditis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>On the basis of our sample of children with SAB, additional blood cultures to document sterility are not necessary after 2 FUBC results are negative in well-appearing patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2020-1821","type":"journal-article","created":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T13:25:42Z","timestamp":1606310742000},"source":"Crossref","is-referenced-by-count":19,"title":["Follow-up Blood Cultures in Children With <i>Staphylococcus aureus<\/i> Bacteremia"],"prefix":"10.1542","volume":"146","author":[{"given":"Caitlin","family":"Cardenas-Comfort","sequence":"first","affiliation":[{"name":"Section of Pediatric Infectious Diseases, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheldon L.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Section of Pediatric Infectious Diseases, Baylor College of Medicine, Houston, Texas; and"},{"name":"Department of Pediatrics and"},{"name":"Texas Children's Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus G.","family":"Vallejo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and"},{"name":"Section of Pediatric Infectious Diseases, Baylor College of Medicine, Houston, Texas; and"},{"name":"Texas Children's Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Chase","family":"McNeil","sequence":"additional","affiliation":[{"name":"Section of Pediatric Infectious Diseases, Baylor College of Medicine, Houston, Texas; and"},{"name":"Department of Pediatrics and"},{"name":"Texas Children's Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,12,1]]},"reference":[{"issue":"1","key":"2021121014074662500_B1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1086\/599348","article-title":"Trends in the incidence of methicillin-resistant Staphylococcus aureus infection in children\u2019s hospitals in the United States","volume":"49","author":"Gerber","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"12","key":"2021121014074662500_B2","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1097\/INF.0000000000000907","article-title":"Staphylococcus aureus bacteremia in children: changes during eighteen years","volume":"34","author":"Cobos-Carrascosa","year":"2015","journal-title":"Pediatr Infect Dis J"},{"issue":"5","key":"2021121014074662500_B3","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1017\/ice.2014.91","article-title":"Staphylococcus aureus bacteremia in hospitalized children: incidence and outcomes","volume":"36","author":"Klieger","year":"2015","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"6","key":"2021121014074662500_B4","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1093\/cid\/ciy1030","article-title":"Epidemiology of bloodstream infections in hospitalized children in the United States, 2009\u20132016","volume":"69","author":"Spaulding","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"3","key":"2021121014074662500_B5","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/j.1469-0691.2006.01589.x","article-title":"Increasing incidence but decreasing in-hospital mortality of adult Staphylococcus aureus bacteraemia between 1981 and 2000","volume":"13","author":"Benfield","year":"2007","journal-title":"Clin Microbiol Infect"},{"issue":"12","key":"2021121014074662500_B6","first-page":"2112","article-title":"Methicillin-susceptible and methicillin-resistant Staphylococcus aureus bacteremia: nationwide estimates of 30-day readmission, in-hospital mortality, length of stay, and cost in the United States","volume":"69","author":"Inagaki","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"6","key":"2021121014074662500_B7","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-0183","article-title":"Epidemiology of methicillin-resistant Staphylococcus aureus bacteremia in children","volume":"139","author":"Hamdy","year":"2017","journal-title":"Pediatrics"},{"issue":"3","key":"2021121014074662500_B8","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1093\/cid\/ciq146","article-title":"Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. [published correction appears in Clin Infect Dis. 2011;53(3):319]","volume":"52","author":"Liu","year":"2011","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2021121014074662500_B9","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1093\/cid\/ciaa039","article-title":"Does this patient need blood cultures? A scoping review of indications for blood cultures in adult nonneutropenic inpatients","volume":"71","author":"Fabre","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"12","key":"2021121014074662500_B10","doi-asserted-by":"crossref","first-page":"ofz494","DOI":"10.1093\/ofid\/ofz494","article-title":"Intermittent negative blood cultures in Staphylococcus aureus bacteremia; a retrospective study of 1071 episodes","volume":"6","author":"Stewart","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"2021121014074662500_B11","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s12879-016-1622-z","article-title":"Sending repeat cultures: is there a role in the management of bacteremic episodes? (SCRIBE study)","volume":"16","author":"Wiggers","year":"2016","journal-title":"BMC Infect Dis"},{"issue":"12","key":"2021121014074662500_B12","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1086\/430312","article-title":"Three-year surveillance of community-acquired Staphylococcus aureus infections in children","volume":"40","author":"Kaplan","year":"2005","journal-title":"Clin Infect Dis"},{"issue":"4","key":"2021121014074662500_B13","first-page":"338","article-title":"Association between vancomycin trough concentrations and duration of methicillin-resistant Staphylococcus aureus bacteremia in children","volume":"7","author":"Hsu","year":"2018","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2021121014074662500_B14","volume-title":"Pediatric Advanced Life Support (PALS) Provider Manual","author":"American Heart Association","year":"2016"},{"issue":"17","key":"2021121014074662500_B15","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1161\/01.CIR.0000013073.22415.90","article-title":"Unique features of infective endocarditis in childhood","volume":"105","author":"Ferrieri","year":"2002","journal-title":"Circulation"},{"issue":"5","key":"2021121014074662500_B16","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1097\/INF.0000000000000195","article-title":"Staphylococcus aureus bacteremia without a localizing source in pediatric patients","volume":"33","author":"Ligon","year":"2014","journal-title":"Pediatr Infect Dis J"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2020-1821\/1080927\/peds_20201821.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2020-1821\/1080927\/peds_20201821.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T03:55:23Z","timestamp":1639194923000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/146\/6\/e20201821\/77092\/Follow-up-Blood-Cultures-in-Children-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,1]]},"references-count":16,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,12,1]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2020-1821","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,1]]},"article-number":"e20201821"}}