Medical care related laboratory-confirmed bloodstream infections in paediatrics

Infez Med. 2015 Jun;23(2):117-24.

Abstract

The aim of this survey was to describe the incidence, epidemiology, microbiology, risk factors and outcome of medical care related laboratory-confirmed bloodstream infections (LCBIs) observed during a twelve-month prospective study in a Paediatric Teaching Hospital in Turin, Italy. Inclusion criteria were clinical signs of sepsis and positivity of one or more of the following tests: blood culture, polymerase chain reaction for bacterial and fungal DNA on blood, and culture on intravascular device tips. In all, 140 episodes of sepsis were documented in 131 children: 37 (26.4%) were healthcare outpatient-associated, 91 (65.0%) healthcare-associated and 12 (8.6%) community-acquired. The overall incidence of healthcare-associated LCBIs was 13.6/1,000 hospitalized patients and incidence density 1.4/1,000 inpatient days. The overall mortality was 3.9%. Forty-seven (36.7%) episodes involved newborns and 107 (83.6%) episodes were observed in children with an indwelling central venous catheter. Coagulase-negative staphylococci (26.8%), Staphylococcus aureus (15.2%), Escherichia coli (8.7%) and Candida spp. (7.2%) were responsible for the majority of cases. 9.5% of S. aureus isolates were methicillin-resistant and 6.5% of Gram negatives were extended-spectrum beta-lactamase-producing. Incidence and epidemiology of medical care related LCBIs were similar to the existing literature data. LCBIs caused by antibiotic-resistant microorganisms were fewer and mortality rate was lower. Most of the LCBIs recorded involved newborns and oncological children.

Publication types

  • Observational Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / diagnosis*
  • Bacteremia / drug therapy
  • Bacteremia / epidemiology
  • Bacteremia / microbiology*
  • Child
  • Child, Preschool
  • Cross Infection / complications*
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Hospitals, Pediatric
  • Hospitals, Teaching
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Pediatric
  • Italy / epidemiology
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Pediatrics*
  • Prospective Studies
  • Risk Factors
  • Staphylococcal Infections / complications*
  • Staphylococcus aureus / isolation & purification
  • Staphylococcus aureus / pathogenicity*

Substances

  • Anti-Bacterial Agents