Bacteraemia among children in hospital--a four year prospective study

The incidence of bacteraemia in children (excluding newborn babies) admitted to a general hospital during the period 1978 to 1981 was 3.2 patients per 1000 admissions. Of the total, nosocomial bacteraemia comprised 0.7 patients per 1000 admissions. Analysis of some probable risk factors showed that the chance of acquiring bacteraemia in the first year of life was 6.8 times that for older children, the difference being statistically significant (P less than 0.001). The male to female ratio was 1.7: but this difference was not statistically significant. Overall the case mortality rate was 4.5%. For nosocomial bacteraemia the rate was much higher (14.3%) than that of community acquired bacteraemia (1.9%) with a risk of dying 7.5 times greater (P less than 0.01). Of the pathogens isolated 71.2 per cent were Gram-negative, Escherichia coli being the most common followed by Salmonella typhi. Among the Gram-positive organisms isolated, as well as overall, the pneumococcus was the most common pathogen. Pneumonia and gastroenteritis were the underlying conditions most often found. Since the pneumococcus was the most common pathogen, and in all of our patients originated in the community, physicians who treat in out-patient clinics as well as emergency rooms should be aware of this and look especially for the early symptoms and signs of disease likely to be caused by this organism.