The role of blood culture in the surveillance of pneumonia and sepsis

1
The role of blood culture in the surveillance of
pneumonia and sepsis

• Kenya Surveillance Sites meeting
• Nairobi KCCT 21st September
• Anthony Scott

2
How much pneumonia is bacteraemic?

• Haemophilus influenzae type b
• The Gambia Hib vaccine trial 1997
• 21 of all cases of radiologically-confirmed
  pneumonia were prevented by Hib vaccine
• Compared to the number of Hib meningitis cases
  there were 5 times as many X-ray proven Hib
  pneumonia cases

3
How much pneumonia is bacteraemic?

• Streptococcus pneumoniae
• The Gambia Pneumococcal Vaccine Trial 2005
• For every 2 cases of invasive pneumococcal
  disease prevented by vaccine there were 15 cases
  of radiologically confirmed pneumonia prevented

4
What BC bacteria are found in pneumonia?
5
What BC bacteria are found in pneumonia?
6
netSPEAR Indications for blood culture

• Clinical Indications for Blood Culture in
  children aged 2 to 60 months.
• A blood culture will be of value in a child aged
  2 months to 60 months with a history of fever,
  who has not already had iv or im antibiotics, and
  one or more of
• Clinical diagnosis of septic shock
• Clinical diagnosis of severe or very severe
  pneumonia
• Severe / Very Severe Pneumonia
• Cough or difficult breathing in the absence of
  asthmawith ONE or more of
• Cyanosed / needs oxygen / oxygen saturation
  lt90
• Unable to drink / breastfeed
• Lower chest wall indrawing