title: Community-acquired bloodstream infections among paediatric patients admitted to an Italian tertiary referral centre: a prospective survey.
abstract: Introduction. Invasive bacterial diseases continue to represent a significant burden in paediatric age, and the emergence of previously secondary bacteria and antibiotic-resistant strains requires a continuous surveillance.  Materials and methods. A one-year prospective survey on laboratory confirmed community-acquired bloodstream infections (CA-LBSIs) cases admitted to an Italian tertiary specialistic paediatric Hospital.  Results. Twelve cases were documented, with an incidence rate of 0.39/1,000 admissions to the Emergency Department, and of 2.9/1,000 hospitalizations to general and specialized wards. Mean age at diagnosis was 5.2 +/- 5.9 years, with 58.3% of episodes regarding children younger than years. Six episodes were caused by Gram positive and six by Gram negative bacteria, with potential vaccine-preventable pathogens responsible of 50% of CA-LBSIs. Empiric antibiotic therapy prescribed at admission was found appropriate to microbiological results in the totality of cases and administered for a mean time of 17.7 +/- 10.1 days. No resistant strains were found. All patients had a good outcome.  Conclusions. Prompt collection of samples for microbiological tests together with the rapid institution of empiric antibiotic therapy are essential for the correct management of CA-LBSIs in paediatric patients. Implementation of vaccinations against the major responsible pathogens remains the most important prevention strategy.
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Turin, Italy.
authors.forename: Carmelina
authors.initials: C
authors.lastname: Calitri
authors.forename: Silvia
authors.initials: S
authors.lastname: Virano
authors.forename: Carlo
authors.initials: C
authors.lastname: Scolfaro
authors.forename: Irene
authors.initials: I
authors.lastname: Raffaldi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: De Intinis
authors.forename: Gabriella
authors.initials: G
authors.lastname: Gregori
authors.forename: Manuela
authors.initials: M
authors.lastname: Bianciotto
authors.forename: Pier-Angelo
authors.initials: PA
authors.lastname: Tovo
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D019538:Health Care Surveys; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D007297:Inpatients / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents