Bacteraemia due to enteropathogenic bacteria in a paediatric hospital in Athens, Greece
Abstract number: P1831
Lebessi E., Doudoulakakis A., Antonaki G., Zouni P., Papadimitriou M., Paleologou N., Kallergi K.
Objective: To review the clinical and bacteriological features of patients with bacteraemia due to enteropathogenic bacteria over a five-year period (20032007).
Methods: We retrospectively reviewed the medical records of all included patients for clinical symptoms, laboratory findings, predisposing factors, treatment and outcome. Blood culture, identification, antimicrobial susceptibility and Salmonella spp. serotyping were performed by standard methods.
Results: We evaluated 42 bacteremic patients (23 boys, 19 girls). The median age was 18 months (35 days-15 years). Fever (93%) and diarrhoea (76%) were the most common initial symptoms, followed by vomiting (31%) and convulsions (7%). Laboratory findings on admission included: median WBC=11.3×109/L (2.9 to 30.6×109/L in children with no underlying disease) and median CRP = 76 mg/L (2 to 374 mg/L). Leukocytosis (>10×109/L) was present in 23/42 (55%) children and CRP > 10 mg/L in 35/42 (83%). Underlying disease was present in five patients (one with congenital heart disease; three haematogical malignancy and one immunodeficiency/hypoglobulinaemia). The involved pathogens were the following: Salmonella enterica (38/42), Campylobacter spp. (3/42) and Aeromonas hydrophila (1/42). S. Enteritidis was the most predominant serovar (24/38, 63%), followed by S. Typhimurium (3/38, 8%). Nine cases were due to other Salmonellae and only one was due to S. Typhi. Two patients presented osteomyelitis; one immunocompetent (S. Kottbus) and one neutropenic with acute myeloblastic leukaemia (A. hydrophila). One child had urinary tract infection due to S. Enteritidis. Overall, 27 patients among 38 tested (71%) had positive stool cultures for the involved bacteria. Twenty out of 38 (53%) patients with Salmonella spp. bacteraemia were given third generation cephalosporins; the remaining were given ampicillin or cotrimoxazole. Recurrent disease was not recorded among the evaluated patients. All but one strains were found susceptible to ampicillin and cotrimoxazole, and all strains were found susceptible to cefotaxime and ciprofloxacin. All three strains of Campylobacter spp. were susceptible to erythromycin and one was resistant to ciprofloxacin.
Conclusions: Bacteraemia associated with enteropathogenic bacteria is a fairly uncommon entity, but it should be considered in children, especially infants with symptoms of febrile gastroenteritis. Focal symptoms are rare and the usual outcome after proper antimicrobial treatment is favourable.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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