Etiology of Community-acquired Bacteremia in Healthy Children

Kim, Hyung Tae; Jang, Hyun Oh; Moon, Jin Soo; Nam, Seung Yeon; Kim, Dong Wook; Lee, Chong Guk; Cho, Chong Rae

Abstract

PURPOSE
A full view of the spectrum of all bacterial diseases in healthy children is essential to the establishment of public health priorities. Accurate information on the relative importance of the various pathogens in terms of the age of the affected patients, the site of infection and the case fatality rate are valuable to the clinician in choosing antimicrobial treatments. METHODS: Fifty-nine episodes of bacteremia were analysed. Data were collected at Ilsan Paik Hospital from January 2000 to December 2003. Analysis of each collected episode included isolating pathogen from blood culture, diagnosis, hospital course, isolating pathogens from other tissue sites, and studying results of antimicrobial sensitivity tests. RESULTS: Fifty-nine cases of community-acquired bacteremia were reviewed. The most common pathogen was Staphylococcus aureus (11 cases, 18.6 percent), followed by Salmonella (10 cases, 16.9 percent), E. coli (7 cases, 11.9 percent), Streptococcus pneumoniae (five cases, 8.5 percent), Streptococcus viridans (5 cases 8.5 percent). The most common diagnosis was bacteremia without an indentified focus (61 percent), followed by meningitis (12 percent), bacteremia with enteritis (10.2 percent) and bacteremia with urinary tract infection (8.5 percent). Salmonella was still an important causative agent of bacteremia. The relative importance of Haemophilus influenza and Streptococcus pneumoniae was lower than in other studies. The most common organism responsible for bacteremia without an identified focus was Staphylococcus aureus The case-fatality was 3.4 percent for all cases of bacteremia. CONCLUSION: We reviewed the etiology of community-acquired bacteremia. These data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infection.