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Published on: February 17, 2023
Epidemiology of bacteremia in a pediatric population - A 10-year study
Mariana Ferreira1, Mafalda Santos1, Jorge Rodrigues1
1Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
Insights
Invasive bacterial infections in children show changing patterns post-vaccination. Streptococcus pneumoniae remains common but may be declining, impacting antibiotic prescribing practices.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Conjugate vaccines for meningococcal and pneumococcal diseases have altered the landscape of invasive bacterial infections.
- Understanding current trends in pediatric bacteremia is crucial for public health and clinical practice.
Purpose of the Study:
- To review all cases of bacteremia in a pediatric department over a ten-year period.
- To analyze the prevalence and etiology of invasive bacterial infections in the post-pneumococcal conjugate vaccine era.
Main Methods:
- A retrospective review of positive blood cultures (BC) from 2007 to 2016.
- Classification of BC results as contaminants, potential pathogens, or confirmed pathogens.
- Collection of demographic and clinical data for patients with identified pathogens.
Main Results:
- 120 cases (1.2%) of true bacteremia were identified from 638 positive BC.
- Streptococcus pneumoniae was the most frequent pathogen (29.2%), showing a potential decline.
- Staphylococcus aureus (19.2%) and Escherichia coli (common in infants <3 months) were also significant isolates.
Conclusions:
- The rate of true pediatric bacteremia aligns with recent studies.
- While Streptococcus pneumoniae is still prevalent, its incidence may be decreasing.
- Monitoring microbiological data is essential for informed antibiotic prescribing in pediatric care.
Introduction:
With the widespread introduction of conjugate meningococcal and pneumococcal vaccines, the prevalence and etiology of invasive bacterial infections have changed. We aimed to review all cases of bacteremia in a level II pediatric department over a ten-year period in the post-pneumococcal conjugate vaccine era.
Methods:
We reviewed all positive blood cultures (BC) obtained in our department between 2007 and 2016. Results were classified as contaminants, potential pathogens or confirmed pathogens, based on species, number of positive BC in the episode and the patients' medical history. Demographic and clinical data were collected for patients with identified pathogens.
Results:
A total of 638 positive BC were identified (6.6% of total BC); 120 (1.2%) were considered to represent true bacteremia. The most frequently identified microorganism was Streptococcus pneumoniae (29.2%), with a decrease in the number of cases between 2008 and 2015. Staphylococcus aureus was the second most common organism (19.2%) being 21.7% of these methicillin-resistant. Escherichia coli was the most common isolate in children aged less than three months.
Conclusion:
We found a rate of true bacteremia in children similar to recent studies. Although Streptococcus pneumoniae remains the most common microorganism, its prevalence may be declining. Monitoring microbiological data in children has implications in practice, particularly in local antibiotic prescription.
