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Pediatric bacteremia caused by Hemophilus influenzae type b and Streptococcus pneumoniae is common in children under 10. Hemophilus influenzae type b infections predominantly affect infants, while Streptococcus pneumoniae infections occur more evenly in the first two years of life.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Clinical Microbiology
Background:
- Bacteremia in young children poses significant diagnostic and therapeutic challenges.
- Understanding the epidemiology of common bacterial pathogens is crucial for pediatric care.
- Distinguishing between Hemophilus influenzae type b and Streptococcus pneumoniae infections is vital due to differing clinical presentations and management.
Purpose of the Study:
- To analyze and compare the bacteriology of Hemophilus influenzae type b and Streptococcus pneumoniae infections in a pediatric population.
- To investigate the age distribution, common sources, and clinical characteristics of these bacteremic infections.
- To evaluate the utility of repeat blood cultures in managing occult pneumococcal bacteremia.
Main Methods:
- Retrospective review of bacteriology records from a University Hospital pediatric service over 30 months.
- Identification and analysis of cases with Hemophilus influenzae type b and Streptococcus pneumoniae bacteremia in children under 10.
- Correlation of pathogen type with patient age, identified infection source, and treatment outcomes.
Main Results:
- 42 cases of Hemophilus influenzae type b and 30 cases of Streptococcus pneumoniae bacteremia were identified.
- Hemophilus influenzae type b bacteremia was predominantly seen in children under 2 years (88%), particularly in the first year of life.
- Streptococcus pneumoniae bacteremia occurred more evenly across the first two years of life (7% in <2 years), with otitis media and pneumonia as frequent sources; 37% had no obvious source.
Conclusions:
- Hemophilus influenzae type b bacteremia has a distinct age predilection in infants compared to Streptococcus pneumoniae bacteremia.
- Central nervous system infections were the most common source for Hemophilus influenzae type b, while otitis media and pneumonia were frequent for Streptococcus pneumoniae.
- Repeat blood cultures are valuable in guiding antibiotic therapy for occult pneumococcal bacteremia.
Abstract:
Review of the bacteriology records of a University Hospital pediatric service for a 30-month period revealed 42 patients with Hemophilus influenzae type b bacteremia and 30 patients with Streptococcus pneumoniae bacteremia, all under age 10. Eighty-eight percent of the Hemophilus bacteremias and 7% of the pneumococcal bacteremias occurred in children less than 2 years of age. Hemophilus bacteremia was seen mot frequently in the first year of life, in contrast to pneumococcal bacteremia which was seen evenly throughout the first and second years of life. In all but one of the Hemophilus infections, a definite source of the bacteremia was apparent; these included CNS infection (58%), cellulitis (14%), and pneumonia (12%). In contrast, no obvious source was apparent in 37% of the pneumococcal bacteremias. When a focus for pneumococcal bacteremia was identified, otitis media and pneumonia were the most frequent diagnoses. Most of the occult pneumococcemias were transient; the results of repeat blood cultures before a treatment decision were helpful in determining the necessity for and duration of antibiotic therapy in those patients with no obvious source of infection.