All issues > Volume 35(4); 1992

Original Article

J Korean Pediatr Soc. 1992;35(4):499-507. Published online April 15, 1992.

Polymicrobial Bacteremia in Children

Hyun Seung HS Park¹, Myung Ik MI Lee¹, Soon Wha SW Kim¹, Don Hee DH Ahn¹

¹Department of Pediatrics, National Medical Center, Seoul, Korea

Abstract

A clinical observation was made on 212 cases of bacteremia in children, who were hospitalized at department of pediatrics, National Medical Center from Jan. 1981 to Dec.1988 The results were as follows; 1) Blood culture proven bacteremia were 212 cases in children. Among them polymicrobial bacteremia were 22 cases(10.4%) and monomicrobial bacteremia were 190 cases(89.6%). The same species of bacteria was cultured in the blood and other culture site in 12 cases(5.6%) among polymicrobial bacteremia group and 74 cases(34.8%) in monomicrobial bacteremia group. 2) There noted neonatal cases in 17 among 22 polymicrobial bacteremia group and 103 am ong 190 monomicrobial bacteremia group(p<0.05). The peak age of bacteremia beyond neonatal period was 4~7years of age. 3) Male patient was 13 cases in polymicrobial bacteremia and 116 cases in monomicrobial bacteremia. The overall fatality was 7 cases in polymicrobial bacteremia and 40 cases in monomicrbial bactermia(p<0.05). 4) Clinical features in patients with bacteremia were jaundice, fever, poor feeding, cyanosis, gastrointestinal disturbance including vomiting, poor activity and hepatosplenomegaly. There was no difference between two groups. 5) ESR was 20mm/hr in monomicrobial bacteremia and 9mm/hr in polymicrobial bacteremia. There was no difference in the leukocyte count and the duration of fever, antibiotics use and hospitalization between two groups. 6) The bacteria, which was cultured more commonly in polymicrobial bacteremia compared to monomicrobial bacteremia, was Enterococcus in gram-positive organisms and KIebsella, E. coli and Enterobacter in gram-negative organisms. 7) In polymicrobial bacteremia, gram-negative organisms grew in 11 cases(50.0%) and grampostive organisms grew in 3 cases(13.5%). Mixed infection with gram-negative and gram-po sitive organisms was noted in 6 cases(27.3%). Anaerobes grew in 2 cases(9.2%). 8) Neutropenia(ANC<1500/mm3) was noted in 4 cases in polymicrobial bacteremia and 10 cases in monomicrobial bacteremia(p<0.05). The fatality in neutropenia patients was 25% in polymicrobial bactermia and 10% in monomicrobial bacteremia. 9) C-reactive protein was recorded in 109 cases. Three cases were positive among 8 cases of polymicrobial bacteremia and 55 cases positive among 101 cases of monomicrobial bacteremia(p<0.05). 10) Polymicrobial bacteremia was noted in 17 cases among 120 newborn patients and in 5 patients among 92 patients beyond newborn. It occurred in 14 patients among 57 patients in whom intravascular catheter was used and in 8 patients among 155 patients without intravascular catheter(p<0.05).

Keywords :Polymicrobial bacteremia, Child