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Community-acquiredPseudomonas aeruginosasepsis in previously healthy infants and children: analysis of forty-three episodes

 

作者: YHU-CHERING HUANG,   TZOU-YIEN LIN,   CHING-HUNG WANG,  

 

期刊: The Pediatric Infectious Disease Journal  (OVID Available online 2002)
卷期: Volume 21, issue 11  

页码: 1049-1052

 

ISSN:0891-3668

 

年代: 2002

 

出版商: OVID

 

关键词: Pseudomonas aeruginosa;sepsis;community-acquired;previously healthy infants

 

数据来源: OVID

 

摘要:

Background.Pseudomonas aeruginosasepsis is often considered to be hospital-acquired and to affect mainly children with underlying problems. Fewer than 50 cases of community-acquired sepsis associated withP. aeruginosain previously healthy infants and children have been reported in English language literature.Methods.We retrospectively reviewed the medical records of 121 infants and children younger than 15 years of age who had 124 episodes ofP. aeruginosasepsis and were hospitalized at Chang Gung Memorial Hospital and Chang Gung Children’s Hospital during 1983 and 1998. Forty-three episodes of community-acquired infection occurring in previously healthy children were evaluable for this study.Results.Thirty-two children (74%) were male and 36 (84%) were <1 year of age. Ten patients (23%) died. The onset ofP. aeruginosasepsis occurred during May to October in 34 cases (79%). Fever (91%) and diarrhea (72%) were the 2 most common initial symptoms. On admission leukopenia (leukocyte count <5000/mm3) was present in 24 cases (57%) and in 9 of 10 fatal cases.P. aeruginosawas also isolated from other sites than bloodstream in 25 cases (58%), including 10 (43%) of 23 fecal specimens. The initial antibiotic regimen was inappropriate in 16 cases (38%), and the rate of inappropriate initial antibiotic regimen was significantly higher (P= 0.002) in fatal cases (90%) than that in nonfatal cases (24%).Conclusion.Community-acquiredP. aeruginosasepsis in previously healthy infants is not rare in Taiwan. During warm weather seasons, in infants with fever and diarrhea who suddenly develop a septic appearance, it is advisable to cover forP. aeruginosasepsis with aminoglycosides and/or anti-Pseudomonasbeta-lactam antibiotics.

 

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