Bacteremia in children: Etiologic agents, focal sites, and risk factors
Bacteremia in children: Etiologic agents, focal sites, and risk factors
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DOI：
10.1093/tropej/47.6.356
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发表时间：
2001-12-01
影响因子：
2
通讯作者：
Meqdam, MM
中科院分区：
文献类型：
--
作者：
Nimri, LF;Rawashdeh, M;Meqdam, MM
对210例10岁以下发热儿童进行了前瞻性研究。研究人员对儿科医院就诊或收治的儿童中出现胃肠炎、呼吸道感染和疑似败血症的病例进行了研究。临床和微生物学数据记录在问卷中或从患者病历中获得。大多数败血症儿童（71.3%）年龄小于 1 岁。菌血症的主要来源是胃肠炎（40.4%）、肺炎或支气管肺炎（20%）、脑膜炎（7.4%）和尿路感染（7.4%）。从血液或粪便标本中分离出的主要病原体是革兰氏阳性菌（53.3％），主要是肺炎链球菌和凝固酶阴性葡萄球菌。革兰氏阴性菌（45.6%）主要为大肠杆菌、肺炎克雷伯菌、流感嗜血杆菌、脑膜炎奈瑟菌和耶尔森菌。报告了 1 例白色念珠菌病例（1.1%）。首次报告两例嗜肺巴氏杆菌。死亡率为 4%，主要死于败血症病例。住院时间长（> 10 天）和肠外喂养被确定为危险因素。观察到分离的病原体对几种常用抗生素的耐药性。仅在危及生命的情况下才建议使用抗生素进行经验性治疗。
A prospective study was carried out on 210 cases of children under 10 years of age with fever. Cases of gastroenteritis, respiratory tract infections, and suspected sepsis in children seen or admitted to the pediatric hospital were studied. Clinical and microbiological data were recorded in a questionnaire or obtained from patient medical records. Most of the children with septicemia (71.3 per cent) were less than 1 year old. Focal source of bacteremia was gastroenteritis (40.4 per cent), pneumonia or bronchopneumonia (20 per cent), meningitis (7.4 per cent), and urinary tract infections (7.4 per cent). The predominant pathogens isolated from blood or stool specimens were Gram-positive bacteria (53.3 per cent), mainly Streptococcus pneumoniae and coagulase-negative Staphylococcus spp. The Gram-negative bacteria (45.6 per cent) were mainly Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Yersinia spp. One case of Candida albicans (1.1 per cent) was reported. Pasteurella pneumotropica was reported in two cases for the first time. The mortality rate was 4 per cent, mostly from septicemia cases. Long duration of hospitalization (> 10 days) and parenteral feeding were identified as risk factors. Resistance of the isolated pathogens to several commonly used antibiotics was observed. Empirical treatment with antibiotics is recommended only in life-threatening cases.