Article in Japanese
Changes in pathogens of childhood serious bacterial infection with bacteremia
Akiyoshi NARIAI1), Tomohiro HIRADE1), Akiyoshi HORIE1), Daisuke KOIKE1), Fumihide KATO2)
This study investigated changes in pathogens of childhood serious bacterial infection (SBI) with bacteremia before and after routine immunization against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae at a local tertiary hospital in Shimane prefecture.
Children aged 1 week to 15 years were analyzed from January 2007 to December 2018 by using electronic medical records.
A total of 58 cases were identified, of which 25 were seen from 2007 to 2010 (pre-vaccine era), and 33 from 2011 to 2018 (post-vaccine era). The average number of patients decreased significantly from 6.3 per year in the pre-vaccine era to 4.1 per year in the post-vaccine era with a reduction rate of 35% (p<0.001). The mean age of patients rose significantly from 17 to 25 months (p<0.001).
The most common pathogen in the pre-vaccine era was S. pneumoniae, followed by H. influenzae and Escherichia coli. However, the leading cause in the post-vaccine era was E. coli. Eight out of 12 patients with isolated E. coli were diagnosed as urinary tract infection caused by extended-spectrum β-lactamase-producing strains. Group A streptococcus newly emerged in 3 cases in the post-vaccine era.
The most prevalent clinical diagnoses were bacteremia and meningitis in the pre-vaccine era, while urinary tract infection and bacteremia were diagnosed in the post-vaccine era. Both meningitis and bacteremia decreased with rates of 73% and 57%, respectively. On the other hand, urinary tract infection increased to a rate of 75%.
The pathogens of childhood SBIs with bacteremia have changed over 8 years in the post-vaccine era.
1) Department of Pediatrics, Shimane Central Prefectural Hospital
2) Department of Neonatology, Shimane Central Prefectural Hospital
|Key words||serious bacterial infection, bacteremia, children|
|Received||February 7, 2019|
|Accepted||June 11, 2019|