Demographic and Clinical Characteristics of Campylobacter Bacteremia in Children With and Without Predisposing Factors
Demographic and Clinical Characteristics of Campylobacter Bacteremia in Children With and Without Predisposing Factors
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DOI：
10.1097/inf.0b013e31829baae0
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发表时间：
2013-11-01
影响因子：
3.6
通讯作者：
Greenberg, David
中科院分区：
文献类型：
--
作者：
Ben-Shimol, Shalom;Carmi, Adi;Greenberg, David
背景资料：弯曲杆菌是儿童胃肠炎的常见原因，很少引起菌血症，主要在免疫功能低下的儿童中报道。我们的目的是比较儿童弯曲杆菌菌血症（CB）的人口统计学和临床特征之间的儿童和无CB.Methods的危险因素：一项回顾性的，以人群为基础的研究，在1989年和2010年之间进行。危险因素被定义为免疫缺陷，恶性肿瘤，极端早产或慢性疾病与nutritional.Results：76 CB发作（1每儿童/月）被确定为14例儿童的危险因素（30次）和46名儿童没有危险因素（46次）。与无风险因素的儿童相比，有风险因素的儿童年龄较大（平均年龄120.0 +/- 72.8 vs. 16.2 +/- 27.6个月），男性比例较高（90.0% vs. 60.9%），胃肠道症状较少（43.3% vs. 69.9%），住院率较高（96.7% vs. 69.6%）。空肠弯曲菌和结肠弯曲菌（46/47个鉴定菌种）是两组中最常见的菌种。阳性弯曲杆菌粪便培养仅在无危险因素的儿童中发现（0%对38.5%）。未观察到死亡病例。所有菌株的抗生素敏感性测试大环内酯类和碳青霉烯类。结论：儿童CB是罕见的以色列南部。这种疾病表现为以前健康的幼儿的单一胃肠炎并发症，或在年龄较大的免疫受损儿童中反复发作，通常没有胃肠道症状。这种差异可能反映了发病机制的差异，疾病的免疫能力是依赖于病原体的毒力，而疾病的免疫功能低下是宿主依赖性。疾病的结果通常是有利的，大环内酯类仍然是抗生素治疗的选择。
Background: Campylobacter, a common cause of childhood gastroenteritis, rarely causes bacteremia, which is reported mainly in immune-compromised children. Our aim was to compare demographic and clinical characteristics of childhood campylobacter bacteremia (CB) between children with and without risk factors for CB.Methods: A retrospective, population-based study, conducted between 1989 and 2010. Risk factors were defined as immunodeficiency, malignancy, extreme prematurity or chronic diseases with malnutrition.Results: Seventy-six CB episodes (1 per child/month) were identified in 14 children with risk factors (30 episodes) and 46 children without risk factors (46 episodes). Children with risk factors were older (mean age 120.0 +/- 72.8 vs. 16.2 +/- 27.6 months) with higher proportion of males (90.0% vs. 60.9%), less gastrointestinal symptoms (43.3% vs. 69.9%) and higher hospitalization rates (96.7% vs. 69.6%) compared with children without risk factors. Campylobacter jejuni and Campylobacter coli (46/47 of identified species) were the most common species in both groups. Positive campylobacter stool cultures were found only in children without risk factors (0% vs. 38.5%). No mortality cases were observed. All isolates tested for antibiotic susceptibility were sensitive to macrolides and carbapenems.Conclusions: Childhood CB is rare in southern Israel. The disease manifests as a single gastroenteritis complication in a previously healthy young child or as recurrent episodes in an older, immune-compromised child, usually without gastrointestinal symptoms. This disparity may reflect pathogenesis differences, with disease in the immune-competent being dependent on pathogen virulence, whereas disease in the immune-compromised being host dependent. Disease outcome is usually favorable, and macrolides remain the antibiotic treatment of choice.