Vaccination News Home Page                                            subscribe Vaccination NewsLetter

http://archpedi.ama-assn.org/cgi/content/abstract/157/4/389

Arch Pediatr Adolesc Med  

 

Vol. 157 No. 4, April 2003 TABLE OF CONTENTS
  Featured Link
 •  E-mail Alerts
Article

 

Risk of Bacteremia in Young Children With Pneumonia Treated as Outpatients

Samir S. Shah, MD; Elizabeth R. Alpern, MD; Lisa Zwerling, MD, MPH; Karin L. McGowan, PhD; Louis M. Bell, MD
 

Arch Pediatr Adolesc Med. 2003;157:389-392.

Background  Blood cultures are often obtained as part of the evaluation of children with pneumonia. There are few data regarding the risk of bacteremia with pneumonia in children since introduction of the Haemophilus influenzae type b vaccine.

Objective  To evaluate the risk of bacteremia in young children with pneumonia who were treated as outpatients.

Methods  A retrospective cohort study of 580 children aged 2 to 24 months who were evaluated by blood culture in a tertiary care children's hospital emergency department between February 1, 1993, and May 31, 1996, and discharged with the diagnosis of pneumonia.

Results  The mean patient age was 14.1 months; 339 patients (58.4%) were boys. Thirty-eight patients (6.6%) reported the use of oral antibiotics before initial emergency department evaluation. The prevalence of bacteremia was 1.6% (95% confidence interval, 0.7%-2.9%). Streptococcus pneumoniae was the causative organism in all 9 cases. The serotype was available for 8 of 9 cases. Six (75%) of 8 cases of S pneumoniae bacteremia were caused by serotypes included in the current heptavalent pneumococcal conjugate vaccine, which was not available at the time of this study. The contamination rate was 1.9% (95% confidence interval, 1.0%-3.4%). The mean ± SD time to blood culture positive for organisms in a continuously monitored system was significantly shorter for pathogens (13.9 ± 1.3 hours) than for contaminants (21.2 ± 6.1 hours; P = .01).

Conclusions  Children aged 2 to 24 months with pneumonia who are treated as outpatients are at low risk of bacteremia. Widespread use of the pneumococcal conjugate vaccine may further decrease the incidence of bacteremia in this population.


From the Divisions of General Pediatrics (Drs Shah, Zwerling, and Bell), Infectious Diseases (Drs Shah, McGowan, and Bell), and Emergency Medicine (Drs Alpern and Bell), The Children's Hospital of Philadelphia, Philadelphia, Pa. Dr Zwerling is now with the Department of Emergency Medicine, Children's Hospital of Los Angeles, Los Angeles, Calif.

RELATED ARTICLES IN ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE

This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2003;157:315.
FULL TEXT  

 
HOME | CURRENT ISSUE | PAST ISSUES | COLLECTIONS | CONTACT US | HELP
© 2003 American Medical Association. All Rights Reserved.

 

Vaccination News Home Page

 

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.