Rachel Bousfield, Miliya Thyl, Orng Samol, Loet Rithea, Soeng Sona, Hor Put Chhat, Sar Poda, Cartin E. Moore, Kheng Chheng, Varun Kumar, Nicholas P. J. Day & Christopher M. Parry
Background: Blood cultures are used to confirm a diagnosis of enteric fever but reported sensitivities can be as low as 40%.
Aims: To determine the factors associated with a negative blood culture in Cambodian children with suspected enteric fever.
Methods: In a retrospective study of hospitalised Cambodian children given a discharge diagnosis of enteric fever, the following factors associated with a negative blood culture were analysed: age, blood culture volume, prior antibiotic therapy, duration of illness and disease severity.
Results: In 227 hospitalised Cambodian children with a discharge diagnosis of enteric fever, it was confirmed in 70% by a positive blood culture. There was no association between a negative blood culture and younger age, lower blood volumes for culture, prior antibiotic therapy, a late presentation or milder disease.
Conclusions: Although blood culture sensitivity was higher than expected, alternative simple, rapid and sensitive tests are needed for diagnosing enteric fever.
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