COMMUNITY-ACQUIRED BACTEREMIA IN A PEDIATRIC HOSPITAL

Information was collected retrospectively for one year on children pre senting with community acquired bacteremia to a paediatric hospital, B etween Ist October 1996 and 31st September 1997, Thirty eight children were identified (21 males and 17 females). Twenty nine (76%) patients presented directly to the accident and emergency department, Ages ran ged from one week to 14 years (mean 22.8 months, median 8 months). Sym ptoms occurred for 12 hours to 7 days (mean 2.2 days,median I day) pri or to presentation and included fever (63%), vomiting (31%), lethargy (31%), poor feeding(28%), irritability (26%), and diarrhoea (8%). A pr obable source for the bacteremia was identified retrospectively in a t otal of 17 cases; urinary tract infection (7), skin infection (6), sep tic arthritis (2), and pneumonia (2), Organisms included N.meningitide s (29%), S.pneumococcus (26%), E.coli (18%) and S.aureus (21%). No sig nificant resistance patterns were identified. Initial empiric antibiot ic therapy included cefotaxime in 23 (61%) cases, Thirty five (90%) pa tients experienced complete recovery, Three (8%) patients suffered ser ious sequelae, The introduction of national HiB vaccination appears to have impacted on the incidence of community acquired bacteremia espec ially in the younger age group. Patient outcome following community ac quired bacteremia is generally good. Antibiotic resistance,has not yet emerged as a significant problem but current choice of empiric antibi otic therapy may need to be reviewed, Accident and emergency departmen ts are continuing to be used as primary care centres for sick children in Dublin.