Korean J Pediatr.  2005 Nov;48(11):1193-1200.

Clinical Entities and Etiology of Invasive Bacterial Infections in Apparently Healthy Children

Affiliations
  • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. hoanlee@snu.ac.kr
  • 2Cancer Center Hospital, Seoul, Korea.
  • 3National Police Hospital, Seoul, Korea.

Abstract

PURPOSE
Invasive bacterial infection is a major cause of morbidity and mortality in children. Previously, we reported etiology of invasive infections in healthy children in 1985-1995. This study was performed to update etiology of invasive bacterial infections in the previously healthy children. METHODS: We reviewed medical records of 98 episodes of invasive bacterial infections in immunocompetent children at the Seoul National University Children's Hospital in 1996-2004. RESULTS: The frequent pathogens identified over all age groups were Streptococcus pneumoniae (33 %) and Staphylococcus aureus (33%). The proportion of Salmonella species and Haemophilus influenzae has been declined to 4% each from 23% and 14%, respectively, compared to previous study. S. agalactiae was the most common isolate in the infants < or =3 months. Among the infants and children aged 3 months to 2 years and children of 2-5 years, S. pneumoniae (57%, 52%, respectively, in each group) was the most common isolates followed by S. aureus (17% and 24%, respectively). S. aureus was the most common isolates (73%) in children > 5 years. Primary bacteremia was the most common clinical diagnosis (27%). S. pneumoniae was responsible for 42% of primary bacteremia, 50% of meningitis, and 69% of bacteremic pneumonia and empyema. S. aureus accounted for 80% of bone and joint infections. The case fatality rate was 8.1% for all invasive infections. CONCLUSION: We reviewed frequency of bacterial agents of invasive infections in children. The data may be useful for pediatricians to select adequate empirical antibiotics in the management of invasive bacterial infections.

Keyword

Bacterial infections; Bacteremia; Meningitis; Streptococcus pneumoniae; Staphylococcus aureus
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