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[Bacteraemia in children in Iceland 1994-2005]

Sigurdur Arnason, Valtýr Stefánsson Thors, Thórólfur Gudnason

    Laeknabladid
    |July 2, 2008
    PubMed

    Insights

    This study analyzed pediatric blood cultures in Iceland, finding increasing macrolide resistance in common bacteria and confirming the effectiveness of meningococcal C vaccination in children.

    Area of Science:

    • Pediatric Infectious Diseases
    • Clinical Microbiology
    • Epidemiology

    Background:

    • Positive blood cultures in children often indicate serious bloodstream infections requiring prompt, age-appropriate treatment.
    • Accurate data on bacterial prevalence and antibiotic susceptibility are crucial for guiding empirical antibiotic therapy and vaccination strategies.

    Purpose of the Study:

    • To investigate epidemiological parameters of positive bacterial blood cultures in Icelandic children aged 0-18 years.
    • To inform empirical antibiotic treatment and vaccination programs based on local resistance patterns and pathogen prevalence.

    Main Methods:

    • Retrospective analysis of all positive bacterial blood cultures from children (0-18 years) at Landspitali University Hospital (1994-2005).
    • Data collected included patient age, sex, bacterial etiology, collection date, and antimicrobial susceptibility.
    • Children were categorized into four age groups: neonates, infants, preschool, and school-aged.

    Main Results:

    • 1253 positive blood cultures from 974 children were analyzed; 47.4% were from children under one year old.
    • Coagulase-negative staphylococci were most common (37%). Among definite infections, Streptococcus pneumoniae (21.7%), Staphylococcus aureus (19.8%), and Neisseria meningitidis (15.2%) predominated.
    • Macrolide resistance was high in pneumococci (19%) and group A streptococci (33%). No N. meningitidis serogroup C was isolated post-vaccination launch in 2002.

    Conclusions:

    • Findings provide essential data for empirical antibiotic therapy and vaccination strategies in Icelandic children.
    • Rising macrolide resistance reduces the effectiveness of these antibiotics for empiric treatment of pediatric sepsis.
    • Meningococcal C vaccination demonstrated high efficacy; results aid in predicting pneumococcal vaccine effectiveness.
    Abstract

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