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Pseudomonas septicemia in infants and children: a retrospective analysis of 49 cases
T M Wang1, S C Chen, W J Shian
1Section of Pediatrics, Veterans General Hospital-Taichung, Taiwan, R.O.C.
Insights
Pseudomonas bacteremia in children is often hospital-acquired, with a high mortality rate, especially in infants. Combination antibiotic therapy may improve outcomes for this serious pediatric infection.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Hospital Epidemiology
Background:
- Pseudomonas bacteremia is a significant cause of morbidity and mortality in pediatric populations.
- Understanding the epidemiology and risk factors is crucial for effective management.
Purpose of the Study:
- To analyze the characteristics, sources, and outcomes of Pseudomonas bacteremia in pediatric patients.
- To identify factors associated with prognosis and evaluate treatment strategies.
Main Methods:
- Retrospective review of 49 pediatric cases of Pseudomonas bacteremia over an 8-year period.
- Analysis of patient demographics, acquisition source, clinical features, and treatment outcomes.
Main Results:
- The annual rate was 1.7 per 1000 discharges; 73.5% were hospital-acquired.
- Mortality was 44.9%, with higher rates in infants (<2 months old).
- Respiratory tract and skin were common sources; combination therapy showed a better outcome than monotherapy.
Conclusions:
- Pseudomonas bacteremia in children, particularly neonates, carries a high mortality risk.
- Hospital-acquired infections are prevalent, highlighting the need for infection control.
- Combination antibiotic therapy appears more effective than monotherapy for improving patient outcomes.
Abstract:
Reviewed 49 cases of Pseudomonas bacteremia which occurred in pediatric patients during an 8-year period showed the annual rate, per 1000 discharges, was 1.7. In most of the patients (73.5%), the disease was hospital-acquired. Male to female distribution was about 3 to 2. The average age of the 49 patients was 1.29 years, and 55.1% were infected at less than 2 months old. Overall mortality was 44.9%; among the mortalities, 63.6% were under two months of age. Clinical features were not characteristic, but the most common sign associated with this infection was fever (42.9%). Ecthyma gangrenosum occurred in only one patient. Respiratory tract and skin were the most frequent sources of the bacteremia. Polymicrobial bacteremia occurred in 18.4%. Patients with shock, pneumonia, inadequate antibiotic therapy or persistent neutropenia had a substantially poorer prognosis. Administration of combination therapy to patients with Pseudomonas bacteremia seemed to be superior to monotherapy for positive outcome.