ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
The Effect of Antibiotic Exposure and Specimen Volume on the Detection of Bacterial Pathogens in Children With Pneumonia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Rate of bacterial positivity following antibiotic initiation: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Effect of Pneumococcal Conjugate Vaccines on Viral Respiratory Infections: A Systematic Literature Review.The Journal of infectious diseases · 2024Pooled it
- Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge.BMC infectious diseases · 2024Pooled it
- Fast Microbiology: A Pilot Study Comparing Culture-Independent Digital PCR and Blood Culture for Pathogen Detection in Sepsis.International journal of molecular sciences · 2026Article
- Clinical profiles of patients with antibiotic-resistant infections at select tertiary hospitals in Uganda: a retrospective study of clinical records.BMC infectious diseases · 2026Article
- Comparative Effectiveness of Azithromycin Versus Doxycycline in Hospitalized Patients With Community-Acquired Pneumonia Treated With Beta-Lactams: A Multicenter Matched Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Targeting surface cell antigen 2 increases sensitivity of Rickettsia typhi detection.PLoS neglected tropical diseases · 2026Article
- Clinical impact of targeted next-generation sequencing in paediatric pneumonia management: a real-world study evaluating diagnostic concordance and antimicrobial stewardship across multiple specimen types.Italian journal of pediatrics · 2026Article
- Prevalence and Antimicrobial Resistance Profiles of Bloodstream Pathogens in Feni, Bangladesh.BioMed research international · 2026Article
- A Novel PCR Panel for Bacterial Detection in Lower Respiratory Tract Infections: A Comparative Study with Culture Results.Pathogens (Basel, Switzerland) · 2025Article
- Elevated uric acid levels, mortality and cognitive impairment in children with severe malaria.Nature medicine · 2025Article
- Bridging the gap in pneumonia prevention: Qualitative insights on vaccine implementation from health leaders in middle-income countries.PLOS global public health · 2025Article
- Assessment of a rapid diagnostic test based on loop-mediated isothermal amplification (LAMP) to identify the most frequent pathogens causing hospital-acquired pneumonia.Frontiers in cellular and infection microbiology · 2025Article
- Oral versus intravenous antibiotic treatment of moderate-to-severe community-acquired pneumonia: a propensity score matched study.Scientific reports · 2024Observational
- Effects of clinically achievable pulmonary antibiotic concentrations on the recovery of bacteria:Journal of clinical microbiology · 2024Article
- Etiology and Clinical Characteristics of Community-Acquired Pneumonia in Korean Children During the Pre-COVID-19 Period, 2015-2020.Journal of Korean medical science · 2023Article
- Subculturing and Gram staining of blood cultures flagged negative by the BACTEC™ FX system: Optimizing the workflow for detection ofFrontiers in microbiology · 2023Article
- Epidemiology and surveillance implications of community-acquired pneumonia in children.Clinical and experimental pediatrics · 2022Article
- Effective Rapid Diagnosis of Bacterial and Fungal Bloodstream Infections by T2 Magnetic Resonance Technology in the Pediatric Population.Journal of clinical microbiology · 2022Article
- Endocarditis Caused by Nontypeable Streptococcus pneumoniae.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
Corrections and comments
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Authors and funding
36 authors at 20 institutions in 11 countries.
Funding
Abstract
BACKGROUND.: Antibiotic exposure and specimen volume are known to affect pathogen detection by culture. Here we assess their effects on bacterial pathogen detection by both culture and polymerase chain reaction (PCR) in children. METHODS.: PERCH (Pneumonia Etiology Research for Child Health) is a case-control study of pneumonia in children aged 1-59 months investigating pathogens in blood, nasopharyngeal/oropharyngeal (NP/OP) swabs, and induced sputum by culture and PCR. Antibiotic exposure was ascertained by serum bioassay, and for cases, by a record of antibiotic treatment prior to specimen collection. Inoculated blood culture bottles were weighed to estimate volume. RESULTS.: Antibiotic exposure ranged by specimen type from 43.5% to 81.7% in 4223 cases and was detected in 2.3% of 4863 controls. Antibiotics were associated with a 45% reduction in blood culture yield and approximately 20% reduction in yield from induced sputum culture. Reduction in yield of Streptococcus pneumoniae from NP culture was approximately 30% in cases and approximately 32% in controls. Several bacteria had significant but marginal reductions (by 5%-7%) in detection by PCR in NP/OP swabs from both cases and controls, with the exception of S. pneumoniae in exposed controls, which was detected 25% less frequently compared to nonexposed controls. Bacterial detection in induced sputum by PCR decreased 7% for exposed compared to nonexposed cases. For every additional 1 mL of blood culture specimen collected, microbial yield increased 0.51% (95% confidence interval, 0.47%-0.54%), from 2% when volume was ≤1 mL to approximately 6% for ≥3 mL. CONCLUSIONS.: Antibiotic exposure and blood culture volume affect detection of bacterial pathogens in children with pneumonia and should be accounted for in studies of etiology and in clinical management.
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Registered trials
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