Children discharged from an emergency department with bacteraemia had lower C-reactive protein and better outcomes...

Area of Science:

• Pediatric Infectious Diseases
• Emergency Medicine
• Clinical Microbiology

Background:

• Bacteremia in children requires careful management to ensure timely treatment and prevent adverse outcomes.
• Identifying clinical predictors for safe discharge in bacteremic children from the emergency department (ED) is crucial for resource optimization and patient safety.

Purpose of the Study:

• To identify common clinical findings in children with bacteremia who were discharged from the ED.
• To evaluate the clinical outcomes of bacteremic children discharged from the ED.

Main Methods:

• Retrospective chart review of children (over one month old) with positive blood cultures in the ED.
• Analysis of clinical data, including C-reactive protein levels, presenting symptoms, and pathogens.
• Comparison of outcomes between discharged children and those admitted.

Main Results:

• Of 250 cases, 68 children were discharged after initial evaluation.
• Discharged children had significantly lower C-reactive protein (50.5 vs 121.7 mg/L) and fewer signs of illness (dyspnea, ill-looking appearance).
• Streptococcus pneumoniae was the most common pathogen; Kingella kingae and Gram-negative bacteria were less prevalent in discharged children. Hospitalization duration was shorter for discharged patients (6.3 vs 9.0 days).

Conclusions:

• Bacteremic children discharged from the ED exhibit distinct clinical characteristics, including lower C-reactive protein and fewer severe symptoms.
• These findings suggest that selected bacteremic children can be safely discharged from the ED with favorable clinical outcomes.
• Lower C-reactive protein and absence of severe symptoms are indicators for favorable outcomes in discharged bacteremic children.