학술논문
Salmonella Bacteremia in Spanish Pediatric Emergency Departments: Uncommon But Not Mild.
Document Type
Academic Journal
Author
Garrido Rodríguez M; From the Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.; Alonso-Cadenas JA; From the Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.; Gómez B; Pediatric Emergency Department, Hospital Cruces, Barakaldo, Spain.; Gangoiti I; Pediatric Emergency Department, Hospital Cruces, Barakaldo, Spain.; Hernández-Bou S; Pediatric Emergency Department, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain.; de la Torre Espí M; From the Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
Source
Publisher: Williams & Wilkins Country of Publication: United States NLM ID: 8701858 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-0987 (Electronic) Linking ISSN: 08913668 NLM ISO Abbreviation: Pediatr Infect Dis J Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Salmonella spp. is an uncommon microorganism in bloodstream infections among pediatric patients in our setting, although in developing countries it is the most common causative organism in blood cultures.
Methods: We describe the children presenting to pediatric emergency departments and diagnosed with Salmonella bacteremia (SB) and identify clinical and laboratory predictors of poor outcome (ie, complications, sequelae and death) by bivariate analysis. We performed an observational study and subanalysis of a multicenter prospective registry, including patients <18 years of age with a positive blood culture obtained at any of the 22 participating Spanish pediatric emergency departments between 2011 and 2016. We considered young age, chronic diseases, immunosuppressive treatment and intestinal flora disruption as risk factors for SB.
Results: Of the 55 patients with SB (3.2% of registered bacteremia), 32 (58.2%) had no risk factors for SB, 42 (76.3%) had a normal pediatric assessment triangle and 45 (81.8%) an associated gastrointestinal infection (acute gastroenteritis or enteric fever). Nine (16.4%) had a poor outcome, including 1 death (1.8%). A poor outcome was more common in patients with an abnormal pediatric assessment triangle [odds ratio (OR): 51.6; 95% confidence interval (CI): 9.2-289.5], an altered physical examination (OR: 15.2; 95% CI: 4.4-58.8) and elevated C-reactive protein (OR: 1.01; 95% CI: 1.005-1.03).
Conclusions: Most SBs were related to a gastrointestinal infection. One in 6 children had a poor outcome; abnormal pediatric assessment triangle on arrival (25% of patients) was the main risk factor identified.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Methods: We describe the children presenting to pediatric emergency departments and diagnosed with Salmonella bacteremia (SB) and identify clinical and laboratory predictors of poor outcome (ie, complications, sequelae and death) by bivariate analysis. We performed an observational study and subanalysis of a multicenter prospective registry, including patients <18 years of age with a positive blood culture obtained at any of the 22 participating Spanish pediatric emergency departments between 2011 and 2016. We considered young age, chronic diseases, immunosuppressive treatment and intestinal flora disruption as risk factors for SB.
Results: Of the 55 patients with SB (3.2% of registered bacteremia), 32 (58.2%) had no risk factors for SB, 42 (76.3%) had a normal pediatric assessment triangle and 45 (81.8%) an associated gastrointestinal infection (acute gastroenteritis or enteric fever). Nine (16.4%) had a poor outcome, including 1 death (1.8%). A poor outcome was more common in patients with an abnormal pediatric assessment triangle [odds ratio (OR): 51.6; 95% confidence interval (CI): 9.2-289.5], an altered physical examination (OR: 15.2; 95% CI: 4.4-58.8) and elevated C-reactive protein (OR: 1.01; 95% CI: 1.005-1.03).
Conclusions: Most SBs were related to a gastrointestinal infection. One in 6 children had a poor outcome; abnormal pediatric assessment triangle on arrival (25% of patients) was the main risk factor identified.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)