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Polymicrobial bacteremia in pediatric patients.

G T Frommell, J K Todd

    American Journal of Diseases of Children (1960)
    |March 1, 1984
    PubMed
    Summary
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    Polymicrobial bacteremia in children is rare, often involving contaminants. When true pathogens are present, gram-negative bacteria are more common than gram-positive, with Enterobacteriaceae frequently identified.

    Area of Science:

    • Medical Microbiology
    • Pediatric Infectious Diseases

    Background:

    • Blood cultures are crucial for diagnosing bloodstream infections in children.
    • Understanding the significance of multiple microorganisms in pediatric blood cultures is essential for accurate diagnosis and treatment.

    Purpose of the Study:

    • To retrospectively analyze the incidence and characteristics of pediatric blood cultures with two or more microorganisms.
    • To classify these cases based on predefined criteria to differentiate polymicrobial bacteremia from contamination.

    Main Methods:

    • Review of 1,352 positive pediatric blood cultures over a 3.6-year period.
    • Retrospective classification of cultures with multiple organisms into polymicrobial bacteremia, mixed bacteremia/contaminant, or multiple contaminants.

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    Main Results:

    • 5.3% of positive cultures (72/1352) yielded two or more microorganisms, affecting 60 patients.
    • 50% were classified as multiple contaminants, 30% as polymicrobial bacteremia, and 20% as mixed bacteremia/contaminant.
    • Gram-negative organisms were more frequently pathogens than gram-positive organisms, which were often contaminants.

    Conclusions:

    • Polymicrobial bacteremia in children is uncommon and often associated with underlying illness or infection focus.
    • Enterobacteriaceae, streptococci, staphylococci, and anaerobes were common in polymicrobial cases, while common pediatric pathogens were underrepresented.