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Paediatric bacteraemias in tropical Australia
Jeremy Er1, Peter Wallis, Samuel Maloney
1Townsville Hospital, Townsville, Queensland, Australia.
Insights
Paediatric bacteraemia in North Queensland shows unique pathogen trends, with declining S. pneumoniae and rising community-acquired MRSA. Empiric sepsis treatment for children in this region requires reconsideration due to these shifts.
Area of Science:
- Paediatric Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Bacteraemia in children is a significant contributor to illness and death.
- Understanding local epidemiological patterns of paediatric bacteraemia is crucial for effective clinical management.
- Monitoring trends in causative pathogens aids in guiding empirical treatment strategies for sick children.
Purpose of the Study:
- To investigate temporal trends of pathogenic organisms responsible for paediatric bacteraemia in North Queensland.
- To assess the contamination rate of blood cultures in a tertiary paediatric centre.
- To compare local bacteraemia patterns with existing published data.
Main Methods:
- A retrospective analysis of 8,385 blood cultures from children was conducted.
- Data spanned a 10-year period from 2001 to 2010 at a North Queensland tertiary centre.
- Blood culture results were audited for positive isolates and contamination rates.
Main Results:
- 696 positive blood cultures (8.3%) identified 70 bacterial species, with Gram-negative bacteria being slightly more prevalent (51.4%).
- The overall bacteraemia rate was 4.7 per 1000 admissions, with a significant contamination rate of 60.6% among positive cultures.
- Notable findings include distinct frequencies of Salmonella and group A Streptococcus compared to other reports, a decline in Streptococcus pneumoniae, and an increase in community-acquired Methicillin-resistant Staphylococcus aureus (MRSA).
Conclusions:
- Paediatric bacteraemia in tropical Australia presents a unique etiological profile.
- The rising prevalence of community-acquired MRSA necessitates a re-evaluation of current empiric sepsis treatment guidelines for children in this region.
- Ongoing surveillance of paediatric bacteraemia pathogens is essential for adapting clinical practice.
Aim:
Bacteraemias in children are an important cause of morbidity and mortality. Knowledge of local epidemiology and trends is important to inform practitioners of likely pathogens in the sick child. This study aimed to determine trends over time in pathogenic organisms causing paediatric bacteraemia in North Queensland and to audit a hospital's blood culture results with respect to contamination rate.
Methods:
This was a retrospective review of 8385 blood cultures collected from children attending a tertiary centre in North Queensland over a 10-year period (2001-2010).
Results:
There were 696 positive blood cultures (8.3%) with 70 different bacterial species detected. Gram-positive and Gram-negative bacteria accounted for 48.6% and 51.4% of isolates, respectively. Overall, bacteraemia accounted for 4.7 per 1000 admissions. The rate of contamination was 60.6% among positive blood cultures and 5.0% for all blood cultures sampled. These results were compared with previous published reports. Notable differences were seen in the frequencies of Salmonella and group A Streptococcus bacteraemias in North Queensland when compared with other reports. There was also a decline in vaccine-preventable infections such as S. pneumoniae and an increasing trend of community-acquired MRSA bacteraemia.
Conclusion:
This study has demonstrated the unique profile of causative pathogens of paediatric bacteraemias in tropical Australia. In light of the increasing prevalence of MRSA, empiric treatment for sepsis for children in this region needs to be reconsidered.
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