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Enterobacter bacteremia in pediatric patients.

P G Gallagher1

  • 1Children's Hospital Medical Center, Cincinnati, Ohio.

Reviews of Infectious Diseases
|September 1, 1990
PubMed
Summary

Enterobacter bacteremia is a serious infection in children, especially those under 18 months. This study highlights key risk factors and outcomes for pediatric Enterobacter infections.

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Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Microbiology
  • Hospital Epidemiology

Background:

  • Enterobacter species are increasingly recognized as significant human pathogens, particularly in vulnerable, hospitalized populations.
  • Previous research on Enterobacter bacteremia has primarily focused on adult patients, leaving a gap in understanding pediatric cases.
  • This study addresses the need for specific data on Enterobacter bacteremia in children.

Purpose of the Study:

  • To review the epidemiologic factors, clinical characteristics, treatment, and outcomes of Enterobacter bacteremia in pediatric patients.
  • To identify risk factors associated with increased mortality in children with Enterobacter bacteremia.
  • To provide insights into the management and prognosis of this infection in a pediatric setting.

Main Methods:

  • Retrospective review of 33 pediatric patients diagnosed with Enterobacter bacteremia over a 5-year period at a children's hospital.
  • Analysis of demographic data, clinical presentation, underlying conditions, infection sources, and prior antibiotic use.
  • Statistical analysis to determine factors associated with mortality, including age, thrombocytopenia, and fever.

Main Results:

  • The study included 33 pediatric patients, with a male-to-female ratio of 1.2:1 and a wide age range (2 days to 24 years).
  • A majority of cases (22/33) were nosocomially acquired, often associated with underlying conditions (32/33) and common sources like the biliary tract and central venous catheters.
  • Overall mortality was 24%, with 18% directly attributable to Enterobacter bacteremia; younger age (<18 months) and thrombocytopenia were significant predictors of mortality.

Conclusions:

  • Enterobacter bacteremia represents a significant cause of morbidity and mortality in pediatric patients, necessitating careful monitoring and management.
  • Younger children, particularly those under 18 months, and patients with thrombocytopenia face a higher risk of mortality.
  • The findings underscore the importance of recognizing Enterobacter as a critical pathogen in pediatric healthcare settings and highlight areas for potential intervention.

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