title: Correlates of high grade and low grade Haemophilus influenzae bacteremia.
abstract: Routine use of the Isolator 1.5 Microbial Tube lysis direct plating blood culture system at our institution since November, 1983, provided a unique opportunity to study bacteremia in children from a quantitative perspective. In a 3-year period, 90 episodes of Haemophilus influenzae bacteremia occurred in immunocompetent outpatients; 83 of these met the criteria for study. Patients with high grade bacteremia (greater than 100 colony-forming units/ml) were more likely to have meningitis than those with low grade bacteremia (less than or equal to 100 colony-forming units/ml); conversely low grade bacteremia patients were more likely to have cellulitis or arthritis. Of 38 meningitis patients those with high grade bacteremia (n = 25) had a significantly shorter duration of illness before presentation than those with low grade bacteremia (median, 1 vs. 3 days; P less than or equal to 0.006). In addition high grade bacteremia patients had significantly lower white blood cell counts (median, 11.4 vs. 17.3 X 10(3)/mm3; P less than or equal to 0.007) and absolute neutrophil counts (5.5 vs. 11.1 X 10(3)/mm3; P less than or equal to 0.01). Only 1 of 8 meningitis patients who were pretreated with appropriate antibiotics had high colony counts compared to 7 of 8 matched controls (P = 0.04).
authors.affiliation: From the Division of Infectious Diseases, Children's Hospital, Philadelphia, PA 19104.
authors.forename: G S
authors.initials: GS
authors.lastname: Marshall
authors.forename: L M
authors.initials: LM
authors.lastname: Bell
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis; D001431:Bacteriological Techniques; D002481:Cellulitis / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006192:Haemophilus Infections / Q000097:blood / Q000175:diagnosis / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000254:growth & development / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D008581:Meningitis / Q000175:diagnosis; D018805:Sepsis / Q000175:diagnosis / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents