Evaluation of Gram-Positive Growths in Blood Culture in the Pediatric Intensive Care Unit: Infection or Contamination?

Objective: Gram-positive organisms are commonly identified in cultures, either as a result of true infection or contamination.This research focused on examining the correlation between commonly used laboratory indicators and clinical results.This study aimed to evaluate the relationship between clinical outcomes and routine laboratory markers, along with antibiotic choices, in pediatric patients with gram-positive culture results in the pediatric intensive care unit (PICU).Methods: A total of 179 PICU patients with gram-positive culture findings were retrospectively analyzed using hospital records from 2016 to 2019.Data collected included demographic information (age, sex), fever status, microbiological results, antibiotic therapy administered, laboratory values, and survival outcomes. Results:The patients had a median age of 33.00 months (IQR: 8.00-66.00).Of the cohort, 109 (60.89%) were male and 70 (39.11%)were female.Positive culture findings were documented in 90 patients (50.3%).Vancomycin was prescribed to 59 patients (33%), while 31 patients (17.3%) received teicoplanin.A total of 34 patients (18.9%) died during hospitalization.The identified microorganisms included Staphylococcus species (n=56, 31.3%),methicillin-resistant Staphylococcus epidermidis (MRSE) (n=81, 45.3%), Staphylococcus aureus (S.aureus) (n=22, 12.3%), Staphylococcus epidermidis (S.epidermidis) (n=15, 8.4%), and methicillin-resistant Staphylococcus aureus (MRSA) (n=5, 2.8%).White blood cell (WBC) and platelet (PLT) counts were significantly higher among survivors compared to non-survivors (p=0.001 and p<0.001, respectively).No statistically significant associations were found between mortality and categorical variables assessed (p>0.05). Conclusion:Gram-positive culture results are frequently encountered in pediatric intensive care units.By evaluating the clinical and laboratory parameters of the patient, it should be evaluated whether there is an infection or contamination, and infections should be treated.