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Pediatric bloodstream infections in metropolitan Australia

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Abstract

Background

Bloodstream infections (BSIs) cause significant morbidity and mortality of children worldwide. The aim of this study was to investigate BSI in children and determine the identity of causative organism and their susceptibility patterns in a metropolitan public hospital in Australia.

Methods

We retrospectively reviewed children aged 0–16 years admitted to a public hospital from January 1, 2010 to August 31, 2014 inclusive, and whose blood cultures revealed bacteraemia. Data were collected regarding patient demographics, species of bacteria isolated, antimicrobial susceptibility of these isolates, and clinical outcomes.

Results

Out of 96 patients with BSI, 55 (57.3%) were males. The median age was 3.35 years (IQR 0.44–7.46), and there were 2 mortalities. Common sites of infection were the respiratory tract (16.6%, n = 16), bone and joints (15.6%, n = 15) and the urinary tract (11.5%, n = 11). The most frequent isolates were Staphylococcus aureus (27.0%), Escherichia coli (14.0%) and Streptococcus pneumoniae (12.0%). Whilst most bacterial isolates displayed susceptibility (> 90%) to common antimicrobial agents, only 57.1% (8/14) of Escherichia coli isolates were susceptible to ampicillin and 58.3% (7/12) were susceptible to co-trimoxazole.

Conclusions

Gram-positive bacteria accounted for the majority of pediatric BSIs, of which invasive pneumococcal disease remains a noteworthy cause. The majority of isolates, except Escherichia coli, were susceptible to commonly used antimicrobials. This study confirms the knowledge of high rates of resistance of Escherichia coli to ampicillin. Therefore, empirical treatment should still include gentamicin. Monitoring of resistance patterns is warranted to ensure that antibiotic therapy remains appropriate.

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Authors and Affiliations

  1. School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia

    Shakif Mohammad Shakur, John Whitehall & Poonam Mudgil

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  1. Shakif Mohammad Shakur
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  2. John Whitehall
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  3. Poonam Mudgil
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Contributions

SMS contributed to data acquisition, data analysis and interpretation, and drafting of the manuscript. JW contributed to conception and design, data analysis and interpretation, and revision of the manuscript. PM contributed to obtaining of the ethics approval, data analysis and interpretation, revision of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Poonam Mudgil.

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Ethics approval

This study was approved by Human Research Ethics Committee of South Western Sydney Local Health District.

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No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

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Shakur, S.M., Whitehall, J. & Mudgil, P. Pediatric bloodstream infections in metropolitan Australia. World J Pediatr 15, 161–167 (2019). https://doi.org/10.1007/s12519-018-00221-3

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