Modern compilation of etiology of invasive bacterial infection in infants

Abstract

Woll et al present the compilation of bacteriologically confirmed bloodstream infection (BSI) and meningitis in infants <60 days of age who were evaluated in 11 children's hospital emergency departments over 5 years, 2011-2016. They also assessed infectious etiologies by weeks of age, and susceptibility of organisms to frequently used regimens for empiric therapy. Of 442 infants identified with confirmed invasive bacterial infection, approximately 80% had BSI, 14% had meningitis with BSI, and 6% had meningitis without BSI. Positive blood cultures represented 2% of those tested, and positive CSF cultures represented 0.7% of samples tested. Group B Streptococcus was the most common pathogen (37%), followed by E coli (31%) and Staphylococcus aureus (10%). More than 95% of pathogens would be expected to be susceptible to an empiric regimen of ampicillin plus gentamicin, or ampicillin plus a third-generation cephalosporin, but only 89% to a third-generation cephalosporin alone. Strengths of the study are its relatively large number of cases, and inclusion of infants evaluated across 11 children's hospitals. The reader should be cognizant that the primary focus of the study was only those infants with BSI or meningitis or both. The data are useful as a reliable summary of relative age-predictable prevalence of the most serious bacterial infections in very young infants, and of empiric antibiotic regimens to provide life-saving therapy empirically on the day of coming to medical attention. Article page 210 ▶ Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency DepartmentsThe Journal of PediatricsVol. 200PreviewTo help guide empiric treatment of infants ≤60 days old with suspected invasive bacterial infection by describing pathogens and their antimicrobial susceptibilities. Full-Text PDF