Related Experiment Video
Updated: Mar 8, 2026
Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
Published on: February 17, 2023
Characteristics of children with microbiologically confirmed invasive bacterial infections in the emergency
Iker Gangoiti1, Juan R Valle1, Mercedes Sota2
1Paediatric Emergency Department, Cruces University Hospital.
Insights
Paediatric invasive bacterial infections (IBI) often affect healthy-appearing children. Short fever duration, non-fever symptoms, and instability indicate severe IBI requiring prompt attention.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Accurate characterization of pediatric invasive bacterial infections (IBI) is crucial for timely antibiotic administration.
- Understanding IBI presentation aids in identifying children needing urgent medical intervention.
Purpose of the Study:
- To characterize the emergency presentation of invasive bacterial infections (IBI) in children under 14 years old.
- To identify risk factors associated with severe outcomes in pediatric IBI.
Main Methods:
- A prospective registry-based cohort study was conducted from 2008 to 2015.
- Included were pediatric patients (<14 years) with confirmed IBI via culture or PCR.
- Severity was defined by death, sequelae, or ICU admission.
Main Results:
- 223 IBIs were reported, predominantly in previously healthy children (83.9%) who appeared well (74%).
- Occult bacteremia and sepsis were the most common diagnoses; Streptococcus pneumoniae and Neisseria meningitidis were the most frequent pathogens.
- Independent risk factors for severe IBI included fever <24h, non-fever symptoms, and poor appearance on arrival.
Conclusions:
- Invasive bacterial infections (IBI) are frequently seen in previously healthy, well-appearing children.
- Streptococcus pneumoniae was the leading cause of death or sequelae among pediatric IBI cases.
- Short fever duration, non-fever symptoms, and instability predict more severe IBI outcomes.
Background:
Determination of the characteristics of paediatric invasive bacterial infections (IBI) is essential for early identification of children requiring immediate antibiotic therapy. The main objective is to characterize the emergency presentation of the IBI among children aged younger than 14 years.
Patients And Methods:
A prospective registry-based cohort study including all patients aged younger than 14 years diagnosed with confirmed IBI (culture or genomic detection using the polymerase chain reaction) was carried out in a paediatric emergency department between 2008 and 2015. Severity criteria were as follows: death, sequelae or admission to the ICU.
Results:
Of the 223 IBIs reported, 187 (83.9%) corresponded to previously healthy patients (median age=19 months) and 165 (74%) were well appearing. The most common diagnoses were occult bacteraemia [60 (26.9%)] and sepsis [56 (25.1%)]. The most frequent pathogens were Streptococcus pneumoniae [68 (30.5%)] and Neisseria meningitidis [42 (18.8%)]. Four (1.8) patients died (S. pneumoniae, 2) and eight (3.5%) had sequelae (S. pneumoniae, 5). The diagnoses and clinical characteristics of the children varied significantly depending on the isolated pathogen. Duration of fever less than 24 h, symptoms other than fever and not being well-appearing upon arrival to the emergency department were independent risk factors for greater severity (area under the receiver operating characteristics curve=0.805; 95% confidence interval: 0.741-0.868).
Conclusion:
IBIs are commonly diagnosed in previously healthy and well-appearing young children. S. pneumoniae was responsible for the majority of deaths or sequelae. Short duration of fever, symptoms other than fever and not being stable on arrival are associated with greater severity.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:27Acute Pyelonephritis I: Introduction
01:25Urinary Tract Infection II: Pathophysiology
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:26Urinary Tract Infection I: Introduction
01:26Urine Studies II: Urine Culture and Sensitivity Test