Bacteremia in children at the University Hospital in Riyadh, Saudi Arabia
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Bacteremia in children at the University Hospital in Riyadh, Saudi Arabia Fahad Abdullah Al-Zamil Riyadh, Saudi Arabia
Original article 118
Background: Bacteremia is a major pediatric health care problem despite the availability of new modalities in the management of this disease. The aim of the present study was to determine the incidence and pattern of bacteremia in pediatric group at a tertiary hospital in Riyadh, Saudi Arabia. Methods: This retrospective study was conducted at the Department of Pediatrics, College of Medicine, King Khalid University Hospital, Riyadh in the period of January 2003 to January 2005. Positive culture was found in 259 patients aged below 15 years with a total of 8244 admissions in the period. Results: The highest incidence of bacteremia was found in patients aged less than 1 year (57.9%), and the majority of patients (30.5%) were infants aged less than 1 month. Staphylococcus aureus was the most common isolated pathogen (18.7%). Prematurity was associated with 13.2% of the cases, and respiratory tract infection (10.1%) and fever (76.1%) were chief complaints. Conclusions: Staphylococcus aureus is the most common isolated pathogen. The most common primary infections are respiratory tract infection and septic meningitis. Klebsiella pneumoniae and E. coli are the most common isolated Gram-negative organisms. World J Pediatr 2008;4(2):118-122 Key words: bacteremia; incidence; Staphylococcus aureus
World J Pediatr, Vol 4 No 2 . May 15, 2008 . www.wjpch.com
Introduction
B
loodstream infection has been a primary concern of physicians for over 80 years. Blood cultures are usually done for the evaluation of sick children with or without evidence of a focus of infection.[1] Many serious infections are associated with bacteremia and the blood culture may be positive even when cultures of the specimens taken from the local area of infection (cerebrospinal fluid, tissue aspirate, synovial fluid) are negative. A report of a positive blood culture without apparent site of infection usually prompts a clinical re-evaluation and search for a primary focus. Septicemia is a pathological condition with a mortality rate varying from 30% to 70% depending on virulence of the pathogen and host factors.[2,3] Bloodstream infection is an important cause of death, giving a rate of 25%-50%.[4] More recently Blomberg et al (2007)[5] reported a mortality of 40% in pediatric patients with laboratory confirmed bacteremia. Bacterial isolation from blood specimen is often associated with high morbidity and mortality particularly among children.[6] In recent years, bloodstream infections due to Gram-positive cocci have increased in frequency and antimicrobial resistance. Staphylococcus aureus bacteremia is a clinical problem with a particularly high incidence and mortality.[7] The majority of bacteremia cases are caused by Staphylococcus spp., Streptococcus spp., Enterobacter spp., Escherichia coli, Klebsiella pneumoniae, and Pseudomonas.[8] Children who are younger than 36 months are at increased risk for bacteremia
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