Polymicrobial bacteremia in children. An 11-year experience

Area of Science:

• Infectious Diseases
• Clinical Microbiology

Background:

• Polymicrobial bacteremia, defined as the presence of multiple bacterial species in the bloodstream, is a serious clinical concern.
• Identifying predisposing factors and clinical features is crucial for managing this rare infection.

Purpose of the Study:

• To determine the incidence and clinical characteristics of polymicrobial bacteremia.
• To identify common predisposing factors and associated mortality rates.

Main Methods:

• Retrospective analysis of clinical records for patients with blood cultures positive for bacterial pathogens over an 11-year period.
• Identification and enumeration of bacterial species in positive blood cultures.
• Review of patient medical histories for underlying conditions and outcomes.

Main Results:

• Polymicrobial bacteremia occurred in 38 patients (0.6%) out of 6302 positive blood cultures.
• Common predisposing factors included gastrointestinal lesions (42%), central venous catheters (34%), malignancy/chemotherapy (24%), and neutropenia (24%).
• The overall mortality rate was 32%, with clinical presentation often indistinguishable from monomicrobial septicemia.

Conclusions:

• Polymicrobial bacteremia is a rare but severe infection, predominantly affecting children with significant underlying medical issues.
• The condition is associated with a high mortality rate and requires prompt recognition and management.
• Underlying conditions significantly contribute to the risk of developing polymicrobial bacteremia.