ArticleThe Journal of infectious diseases2021
Factors Predicting Blood Culture Positivity in Children With Enteric Fever.
Article in The Journal of infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Factors associated with positive blood cultures in children in nine African and Asian countries: the ACORN2 surveillance network.BMJ global health · 2025Article
- Incidence, antimicrobial susceptibility & out of pocket expenditure of severe enteric fever in Chandigarh, north India.The Indian journal of medical research · 2024Article
- Retrospective Review of Blood Culture-Confirmed Cases of Enteric Fever in Navi Mumbai, India: 2014-2018.The American journal of tropical medicine and hygiene · 2023Review
- The Applicability of a 2-Transcript Signature to Identify Bacterial Infections in Children with Febrile Neutropenia.Children (Basel, Switzerland) · 2023Article
- Burden of Typhoid and Paratyphoid Fever in India.The New England journal of medicine · 2023Article
- Typhoid in India: An Age-old Problem With an Existing Solution.The Journal of infectious diseases · 2021Article
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14 authors.
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Abstract
backgroundBlood culture, despite low sensitivity, is the gold standard for enteric fever diagnosis. Understanding predictors of blood culture positivity may help design strategies to optimize enteric fever diagnosis.
methodsA cohort of 6760 children aged 0.5-15 years was followed for 3 years for enteric fever with blood cultures in an automated system, for fevers >3 days. Factors affecting test positivity in fevers and participant-level predictors for culture refusals were analyzed using regression models.
resultsOverall, 6097 suspected typhoid/paratyphoid fever (STF) episodes were reported, of which 5703 (93.5%) STFs had sampling for blood cultures, with 394 (6.5%) refusals. Salmonella enterica serovar Typhi/Paratyphi positivity was culture-confirmed in 3.8% (218/5703) of STF episodes. Older children (odds ratio [OR], 1.96 [95% CI, 1.39-2.77]), larger blood volume inoculated (OR, 2.82 [95% CI, 1.71-4.66]), higher temperatures during fever (OR, 3.77 [95% CI, 2.89-4.91]), and fevers diagnosed as suspected typhoid or acute undifferentiated fever (OR, 6.06 [95% CI, 3.11-11.78]) had a higher probability of culture positivity. Antibiotics before culture did not decrease culture positivity. Blood culture refusals were higher for children from wealthier households or with milder illness.
conclusionsPerforming blood cultures in older children with fever, especially those fevers with toxic presentation and increasing blood volume for inoculation are strategies to improve enteric fever detection in surveillance settings.
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