title: Community-acquired bloodstream infections in children > one month old in southern Israel (1992-2001): epidemiological, clinical and microbiological aspects.
abstract: We studied the epidemiology, microbiology, clinical picture and outcome of community-acquired bloodstream infections (CABI) in children in southern Israel during 1992-2001. Information was collected prospectively by daily surveillance. CABI was diagnosed when a positive blood culture was reported in a patient discharged from the emergency room or during <48 h since admission if hospitalized. There were 1439 CABI episodes in 1396 children aged 1 month to 14 y. CABI incidence was 100/100,000 children with no increase during the study period. Risk of CABI was 3.8 times higher in a Bedouin than in a Jewish child. 1561 bacteria (793, 50%, gram-positive and 768, 49% gram-negative organisms, respectively) and 13 fungi were recovered. Most frequent gram-positive organisms were Streptococcus pneumoniae (509 isolates, 32% of all isolates, 64% of all gram-positive), Staphylococcus aureus (137, 9%, 17%) and Streptococcus pyogenes (46, 3%, 6%). Enterobacteriaceae spp. were the most frequent gram-negative pathogens (279, 18%, 36%), followed by Brucella (205, 13%, 27%). S. pneumoniae was the most common pathogen in children <12 months and 1-5 y age; Brucella was the most frequent pathogen in children >5 y of age. Coverage of 7-valent pneumococcal conjugated vaccine for CABI was 38.5%. 38 (2.7%) patients died; 16 cases were caused by S. pneumoniae.
authors.affiliation: Paediatric Infectious Disease Unit, Soroka University Medical Centre and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Elvira
authors.initials: E
authors.lastname: Gur
authors.forename: Maya
authors.initials: M
authors.lastname: Frank
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
authors.forename: Nehama
authors.initials: N
authors.lastname: Peled
authors.forename: Joseph
authors.initials: J
authors.lastname: Press
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.forename: Eugene
authors.initials: E
authors.lastname: Leibovitz
mesh_terms: D000293:Adolescent; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D017848:Blood-Borne Pathogens / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D009181:Mycoses / Q000453:epidemiology / Q000382:microbiology