2015•Paediatrics and International Child HealthOpen access
A retrospective study of factors which determine a negative blood culture in Cambodian children diagnosed with enteric fever
Rachel Bousfield, Thyl Miliya, Orng Samol, Loet Rithea, Sona Soeng, Hor Put Chhat, Poda Sar, Catrin E. Moore, Kheng Chheng, Varun S Kumar, Nicholas Day, Christopher Martin Parry
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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.