title: Age and risk factors influence the microbial aetiology of bloodstream infection in children.
abstract: OBJECTIVE
  To study the aetiology of bloodstream infections (BSI) in children 0-17 years, the influence of age and underlying co-morbidity on BSI rate, distribution of pathogens and outcome; and to provide data on antimicrobial susceptibility patterns.
  
  
  METHODS
  A retrospective population-based study. Data on blood cultures were collected at yearly intervals during 1998-2008. Information about risk factors, focal infection and outcome was retrieved from the patient charts.
  
  
  RESULTS
  We identified 1097 BSI. The incidence of BSI was 0.4/1000. The age-specific incidence was 2.3/1000 in neonates (0-28 days old) and 0.2/1000 in the age group 6-17 years. Staphylococcus aureus was the most common pathogen. The number of species causing BSI in previously healthy children was lower compared with children with co-morbidity. Most children requiring intensive care had a serious underlying illness. Antimicrobial resistance was rare and did not influence outcome. The case-fatality rate was 14.4% in neonates, 5.4% in children with co-morbidity and 1.7% in previously healthy children.
  
  
  CONCLUSIONS
  Mortality from BSI is low, and a limited spectrum of pathogens is isolated from previously healthy children compared with children with co-morbidity. When choosing empirical therapy for suspected BSI, age and presence of risk factors should be taken into account.
authors.affiliation: Pediatric Infectious Diseases Unit at the Pediatric Emergency Department, Astrid Lindgren's Children Hospital, Stockholm, Sweden. joachim.luthander@karolinska.se
authors.forename: Joachim
authors.initials: J
authors.lastname: Luthander
authors.forename: Rutger
authors.initials: R
authors.lastname: Bennet
authors.forename: Christian G
authors.initials: CG
authors.lastname: Giske
authors.forename: Anna
authors.initials: A
authors.lastname: Nilsson
authors.forename: Margareta
authors.initials: M
authors.lastname: Eriksson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D024881:Drug Resistance, Bacterial; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents