Etiology of childhood bacteremia and timely antibiotics administration in the emergency department

Pediatrics
Adam D IrwinEnitan D Carrol

Abstract

Bacteremia is now an uncommon presentation to the children's emergency department (ED) but is associated with significant morbidity and mortality. Its evolving etiology may affect the ability of clinicians to initiate timely, appropriate antimicrobial therapy. A retrospective time series analysis of bacteremia was conducted in the Alder Hey Children's Hospital ED between 2001 and 2011. Data on significant comorbidities, time to empirical therapy, and antibiotic susceptibility were recorded. A total of 575 clinical episodes were identified, and Streptococcus pneumoniae (n = 109), Neisseria meningitidis (n = 96), and Staphylococcus aureus (n = 89) were commonly isolated. The rate of bacteremia was 1.42 per 1000 ED attendances (95% confidence interval: 1.31-1.53). There was an annual reduction of 10.6% (6.6%-14.5%) in vaccine-preventable infections, and an annual increase of 6.7% (1.2%-12.5%) in Gram-negative infections. The pneumococcal conjugate vaccine was associated with a 49% (32%-74%) reduction in pneumococcal bacteremia. The rate of health care-associated bacteremia increased from 0.17 to 0.43 per 1000 ED attendances (P = .002). Susceptibility to empirical antibiotics was reduced (96.3%-82.6%; P < .001). Health care-associa...Continue Reading

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Citations

Jan 26, 2016·The Pediatric Infectious Disease Journal·Stephen T J RayAndrew Riordan
Aug 28, 2016·Journal of Paediatrics and Child Health·Jessica C RoedigerPhilip N Britton
Mar 15, 2018·Journal of the Pediatric Infectious Diseases Society·James B WoodIsaac P Thomsen
Mar 30, 2020·The Pediatric Infectious Disease Journal·Laila S Al YazidiAlison Kesson
Jun 24, 2017·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Ganesh KumarachandranEmily L Heil
Feb 15, 2020·Open Forum Infectious Diseases·Paul TranJames Todd
Nov 17, 2020·Journal of Paediatrics and Child Health·Amy K FaugnoChristopher C Blyth
Feb 5, 2021·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Halima Dabaja-YounisImad Kassis
Aug 17, 2021·Frontiers in Pediatrics·Ruud G NijmanUNKNOWN PERFORM consortium (Personalized Risk assessment in febrile children to optimize Real-life Management across the European Un

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