Hemoculturas positivas num serviço de pediatria: 2003-2012

Abstract

Introduction: In selected clinical situations is recommended to investigate the child with fever, including performing blood culture.Aim: To analyze positive blood cultures for pathogenic bacteria in a pediatric department, including the most common agents, its evolution, respective antibiotic susceptibility and correlation with some clinical data.Methods: Retrospective analysis of microbiological data of pathogens isolated in blood cultures and clinical data from children aged one month to 17 years, admitted in a pediatric department between 2003 and 2012.Results: During the study period, the annual rate of positive blood cultures for potentially pathogenic bacteria ranged between 0.8% and 2.9%. In total, were isolated 158 pathogenic bacteria and the most common were: Staphylococcus aureus (29,1%), Streptococcus pneumoniae (27,8%), Escherichia coli (10,1%), Enterococcus faecalis (8,2%), Neisseria meningitidis (5,7%) and Streptococcus pyogenes (5,7%). No Neisseria meningitidis were resistant to ampicillin, 9% of Streptococcus pneumoniae had intermediate resistance to penicillin, 8,7% of Staphylococcus aureus were resistant to methicillin and 6,3% of Escherichia coli were resistant to amoxicillin/clavulanic acid. Sixty-seven percent of positive blood cultures for pathogenic bacteria corresponded to children under the age of 36 months. The most relevant diagnoses were: occult bacteremia, pneumonia, sepsis, meningitis and pyelonephritis. A child died due to septic shock (Streptococcus pneumoniae).Conclusion: In the 10 years analyzed, the most common bacteria were: Staphylococcus aureus, Streptococcus pneumoniae and Escherichia coli. The incidence of Neisseria meningitidis after 2005 and Streptococcus pneumoniae after 2007 decreased. Susceptibility of different pathogenic bacteria to antimicrobials remained stable. We emphasize the importance of epidemiological and clinical monitoring of microbiological data.