Publication:

A prospective study to evaluate the utility of blood culture in hospitalized children with community acquired pneumonia (age three months to eighteen years)

Background Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality among children worldwide. Although blood culture is the diagnostic gold standard for bacteremia, its routine use in paediatric CAP is debated due to low yield and contamination risk. To evaluate the diagnostic and prognostic utility of blood culture in hospitalized children with CAP.

Methods A prospective analytical study was conducted among 100 children aged 3 months-18 years admitted with CAP at GBH General Hospital, AIIMS Udaipur (January 2023-July 2025). Demographic, clinical, laboratory and radiological data were recorded. Blood cultures were obtained before antibiotic therapy and processed using standard microbiological methods. Associations between culture results and outcomes were analysed using SPSS v25 (p<0.05).

Results Blood culture was positive in 22% of cases, with Streptococcus pneumoniae as the predominant isolate (45.5%). Positive cultures were significantly associated with ICU admission (81.8%), complications (31.8%), antibiotic escalation (81.8%) and mortality (36.4%) (p<0.001). Kaplan–Meier survival analysis showed markedly lower survival among culture-positive patients (63.6%) compared to culture-negative (98.7%, p<0.001).

Conclusions Blood culture positivity in pediatric CAP signifies severe disease and adverse outcomes. Selective use in moderate-to-severe cases can guide rational antibiotic therapy and improve prognostic assessment.