title: Polymicrobial bacteremia in pediatric patients.
abstract: Of 1,352 positive pediatric blood cultures during a 3.6-year period, two or more microorganisms grew from 72 cultures (5.3%), representing 60 patients. Based on predefined operational criteria for clinical interpretation of blood cultures, these cases were retrospectively classified as polymicrobial bacteremia (each organism, ie, a pathogen, 30%), mixed bacteremia/contaminant (20%), or multiple contaminants (50%). Considered individually, gram-positive organisms were isolated more frequently but were more often judged to be contaminants than the less common gram-negative organisms, which were more often thought to be true pathogens. Although one child did have a combined Streptococcus pneumoniae/Hemophilus influenzae bacteremia, these more common pediatric pathogens were underrepresented in those patients with polymicrobial bacteremia, from whom Enterobacteriaceae, streptococci, staphylococci, and anaerobes were more commonly isolated. Hospitalization for a predisposing illness and/or a focus of infection occurred in 88% of the children with confirmed polymicrobial bacteremia.
mesh_terms: D000293:Adolescent; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002908:Chronic Disease; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000382:microbiology; D008297:Male; D009748:Nutrition Disorders / Q000150:complications; D012189:Retrospective Studies; D018805:Sepsis / Q000382:microbiology*