title: Medical care related laboratory-confirmed bloodstream infections in paediatrics.
abstract: The aim of this survey was to describe the incidence, epidemiology, microbiology, risk factors and outcome of medical care related laboratory-confirmed bloodstream infections (LCBIs) observed during a twelve-month prospective study in a Paediatric Teaching Hospital in Turin, Italy. Inclusion criteria were clinical signs of sepsis and positivity of one or more of the following tests: blood culture, polymerase chain reaction for bacterial and fungal DNA on blood, and culture on intravascular device tips. In all, 140 episodes of sepsis were documented in 131 children: 37 (26.4%) were healthcare outpatient-associated, 91 (65.0%) healthcare-associated and 12 (8.6%) community-acquired. The overall incidence of healthcare-associated LCBIs was 13.6/1,000 hospitalized patients and incidence density 1.4/1,000 inpatient days. The overall mortality was 3.9%. Forty-seven (36.7%) episodes involved newborns and 107 (83.6%) episodes were observed in children with an indwelling central venous catheter. Coagulase-negative staphylococci (26.8%), Staphylococcus aureus (15.2%), Escherichia coli (8.7%) and Candida spp. (7.2%) were responsible for the majority of cases. 9.5% of S. aureus isolates were methicillin-resistant and 6.5% of Gram negatives were extended-spectrum beta-lactamase-producing. Incidence and epidemiology of medical care related LCBIs were similar to the existing literature data. LCBIs caused by antibiotic-resistant microorganisms were fewer and mortality rate was lower. Most of the LCBIs recorded involved newborns and oncological children.
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Virano
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Scolfaro
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Garazzino
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: De Intinis
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Ghisetti
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Raffaldi
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Carmelina
authors.initials: C
authors.lastname: Calitri
authors.affiliation: Department of Paediatrics II, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Microbiology Laboratory, ASO Regina Margherita Children's Hospital, S. Anna; Microbiology and Virology Laboratory, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Pier Angelo
authors.initials: PA
authors.lastname: Tovo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000150:complications*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006776:Hospitals, Pediatric; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007558:Italy / Q000453:epidemiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D010372:Pediatrics; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications*; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity*
chemical_list: D000900:Anti-Bacterial Agents