Clinical Entities and Etiology of Invasive Bacterial Infections in Apparently Healthy Children

Lee, Joon Ho; Song, Eun Kyoung; Lee, Jin A; Kim, Nam Hee; Kim, Dong Ho; Park, Ki Won; Choi, Eun Hwa; Lee, Hoan Jong

Abstract

PURPOSE
Invasive bacterial infection is a major cause of morbidity and mortality in children. Previously, we reported etiology of invasive infections in healthy children in 1985-1995. This study was performed to update etiology of invasive bacterial infections in the previously healthy children. METHODS: We reviewed medical records of 98 episodes of invasive bacterial infections in immunocompetent children at the Seoul National University Children's Hospital in 1996-2004. RESULTS: The frequent pathogens identified over all age groups were Streptococcus pneumoniae (33 %) and Staphylococcus aureus (33%). The proportion of Salmonella species and Haemophilus influenzae has been declined to 4% each from 23% and 14%, respectively, compared to previous study. S. agalactiae was the most common isolate in the infants < or =3 months. Among the infants and children aged 3 months to 2 years and children of 2-5 years, S. pneumoniae (57%, 52%, respectively, in each group) was the most common isolates followed by S. aureus (17% and 24%, respectively). S. aureus was the most common isolates (73%) in children > 5 years. Primary bacteremia was the most common clinical diagnosis (27%). S. pneumoniae was responsible for 42% of primary bacteremia, 50% of meningitis, and 69% of bacteremic pneumonia and empyema. S. aureus accounted for 80% of bone and joint infections. The case fatality rate was 8.1% for all invasive infections. CONCLUSION: We reviewed frequency of bacterial agents of invasive infections in children. The data may be useful for pediatricians to select adequate empirical antibiotics in the management of invasive bacterial infections.