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Published on: February 9, 2011
Current pathogen profile for bacteremia in a tertiary care pediatric emergency department in Canada
Alino Demean Loghin1, Brandon Noyon1, Charlotte Grandjean-Blanchet2
1Faculté de médecine de l'Université de Montréal, Montréal, Qc, Canada.
Insights
Pediatric bacteremia is often caused by Staphylococcus aureus, E. coli, and Streptococcus pneumoniae. Key predictors include internal devices, young age, and immunosuppression, guiding crucial clinical management.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Bacteremia in children poses significant risks, including septic shock, meningitis, and mortality.
- Identifying common pathogens and their predictors is vital for effective, life-saving interventions.
Purpose of the Study:
- To determine the prevalent pathogens causing bacteremia in pediatric patients presenting to the emergency department (ED).
- To identify variables associated with pediatric bacteremia for improved clinical assessment.
Main Methods:
- Retrospective cohort study of children with positive blood cultures in the ED of a tertiary pediatric hospital (2018-2024).
- True bacteremia cases identified via medical record review by two raters.
- Analysis of pathogen distribution and associated independent variables including demographics, vaccination status, travel, and clinical presentation.
Main Results:
- The most common pathogens identified were Staphylococcus aureus (25%), Escherichia coli (16%), Streptococcus pneumoniae (9.0%), and non-typhoidal Salmonella (8.7%) among 368 cases.
- Risk factors were present in 48% of cases, notably internal devices (22%), age <3 months (16%), and immunosuppression (15%).
- Significant associations included internal devices with Staphylococcus spp. (34%), recent travel with Salmonella spp. (62%), age <3 months with E. coli (38%) and group B Streptococcus (69%).
Conclusions:
- This study provides current insights into key pathogens and predictors of pediatric bacteremia.
- Clinicians should consider travel history, presence of internal hardware, patient age, and immunosuppression status for effective assessment and management of pediatric bacteremia.
Importance:
Bacteremia in children can lead to septic shock, meningitis or death. Knowledge of common pathogens and predictors is crucial for appropriate lifesaving management.
Objective:
We aimed to identify pathogens and associated variables in children with bacteremia presenting to the emergency department (ED).
Methods:
This retrospective cohort study was conducted in a tertiary pediatric hospital in Montreal, Canada (2018-2024). The full cohort included all children with a positive blood culture drawn in the ED while this study focused on cases of true bacteremia identified through medical record evaluation by two raters. The primary outcome was pathogen distribution. Potential pathogen-associated independent variables included demographics, vaccination status, recent travel, clinical presentation, and known risk factors. The primary analysis focused on pathogen prevalence, while secondary analysis assessed associations between predictors and pathogens using Chi-squared tests.
Results:
Among 368 bacteremia cases (median age: 39 months), the most common pathogens were Staphylococcus aureus (25%), Escherichia coli (16%), Streptococcus pneumoniae (9.0%) and non-typhoidal Salmonella (8.7%). Overall, 175 (48%) had risk factors, including internal devices (n = 80, 22%), age less than 3 months (n = 59, 16%), or immunosuppression (n = 55, 15%). Significant associations emerged: 34% (n = 38) of Staphylococcus spp. infections involved internal devices, 62% (n = 24) of Salmonella spp. infections had recent travel, and 38% (n = 22) of E. coli infections and 69% (n = 11) of group B Streptococcus infections occurred in infants aged under 3 months.
Conclusions:
Our study highlights current key pathogens and associated predictors in pediatric bacteremia. Travel history, internal hardware, age, and immunosuppression are crucial for clinicians to consider in its assessment and management.
