RESUMEN
AIM: Escherichia coli (E coli) is a known cause of paediatric bacteraemia. The main objective was to characterise the emergency department (ED) presentations of paediatric E coli bacteraemia and secondarily to identify those related to greater severity. METHODS: This was a sub-study of a multicentre cross-sectional prospective registry including all with E coli bacteraemia episodes between 2011 and 2016. We used multiple correspondence and cluster analysis to identify different patterns. RESULTS: We included 291 patients and 43 met criteria for severe disease (14.3%, 95% confidence interval 11.2-19.3). We identified four types of paediatric E coli bacteraemia presentations. Two (178 patients, 61.2%) were related to well-appearing previously healthy infants with associated urinary tract infection (UTI). Well-appearing children older than 12 months old with underlying disease (n = 60, 20.6%) and non-well-appearing children of different ages (n = 53, 18.2%) corresponded to the other two types; these had associated UTI infrequently and higher severity rate (15% and 50.9%, respectively, higher when compared with the two previous types, P < .01), including the two patients who died. CONCLUSION: There were four different types of ED paediatric E coli bacteraemia presentations with different severity. Febrile young children with associated UTI showed the best outcome.
Asunto(s)
Bacteriemia , Infecciones por Escherichia coli , Infecciones Urinarias , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Niño , Preescolar , Estudios Transversales , Servicio de Urgencia en Hospital , Escherichia coli , Infecciones por Escherichia coli/diagnóstico , Infecciones por Escherichia coli/epidemiología , Humanos , Lactante , Factores de Riesgo , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiologíaRESUMEN
We carried out a prospective multicenter study including 203 previously healthy well-appearing children who were 3-24 months old with fever without a source ≥40.5°C. Thirty-one (15.3%, 95% confidence interval 11.0-20.9) were diagnosed with serious bacterial infection, including 6 with bacteremia (3%, 95% confidence interval 1.4-6.3). Testing for occult bacteremia in children 3-24 months old with fever without a source should be considered when fever at ≥40.5°C.