Characteristics and Prevalence of Bacteremia in Febrile Children With Cancer: Is a Peripheral Blood Culture Necessary?

Many guidelines recommend a peripheral and central blood culture in febrile children with cancer, although data on the utility of the former are scarce. We aimed to report the prevalence and predictors of bacteremia in this cohort, and the utility of a peripheral blood culture in identifying missed bacterial infections. This was a single-center, retrospective study of febrile children with cancer. Between 2014 and 2018, we compared the group with at least one positive blood culture to the group without. We identified 342 unique febrile visits with a mean age of 7.6 years. Fifteen (4%) had bacteremia: 1 only peripheral, 11 only central, 3 both peripheral and central. The odds of bacteremia increased with reinduction chemotherapy (adjusted odds ratio [aOR] = 4.68 [1.13-19.42]) and decreased in children older than 3 years (aOR = 0.27 [0.09-0.80]). In conclusion, our rates of bacteremia were low and the utility of peripheral blood cultures was limited.