Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children
Previous studies examining bacteremia in hospitalized children with pneumonia are limited by incomplete culture data. We sought to determine characteristics of children with bacteremic pneumonia using data from a large prospective study with systematic blood culturing. Children
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| Veröffentlicht in: | Pediatrics (Evanston) 2019-07, Vol.144 (1), p.1 |
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| creator | Fritz, Cristin Q Edwards, Kathryn M Self, Wesley H Grijalva, Carlos G Zhu, Yuwei Arnold, Sandra R McCullers, Jonathan A Ampofo, Krow Pavia, Andrew T Wunderink, Richard G Anderson, Evan J Bramley, Anna M Jain, Seema Williams, Derek J |
| description | Previous studies examining bacteremia in hospitalized children with pneumonia are limited by incomplete culture data. We sought to determine characteristics of children with bacteremic pneumonia using data from a large prospective study with systematic blood culturing.
Children |
| doi_str_mv | 10.1542/peds.2018-3090 |
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| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6615516</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A592627415</galeid><sourcerecordid>A592627415</sourcerecordid><originalsourceid>FETCH-LOGICAL-c522t-aea1bf8e770fb1fbd296a2737882f2edc468296f213459a3540953a64d4c55bd3</originalsourceid><addsrcrecordid>eNpdkc1P3DAQxa0KVLa01x4rS1x6IIs_4-SCtF2VFoS0qGrPluNMFkNiL3aC2v--jpaiwmmkmd88zZuH0EdKllQKdraDNi0ZoVXBSU3eoAUldVUIpuQBWhDCaSEIkUfoXUp3hBAhFXuLjjhlVOWFBbq6ifBoevAWTvEPl-7xhbFjiOkUG9_izTTaMEDCocNf8gAiDM7iGw_TELwz2Hm8vnV9G8G_R4ed6RN8eKrH6NfF15_r78X15tvlenVdWMnYWBgwtOkqUIp0De2altWlYYqrqmIdg9aKssqtjlEuZG24FKSW3JSiFVbKpuXH6Hyvu5uaIfPgx2h6vYtuMPGPDsbplxPvbvU2POqypFLSMgt8fhKI4WGCNOrBJQt9bzyEKWnGhKCc0opn9OQVehem6LO9TMlKcaHETBV7aps_qZ23wY_wO3-u72ELOrtfb_RK1qxkSlCZ-eWetzGkFKF7Pp4SPceq51j1HKueY80Ln_63_Iz_y5H_BfO4nIg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2258734743</pqid></control><display><type>article</type><title>Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Fritz, Cristin Q ; Edwards, Kathryn M ; Self, Wesley H ; Grijalva, Carlos G ; Zhu, Yuwei ; Arnold, Sandra R ; McCullers, Jonathan A ; Ampofo, Krow ; Pavia, Andrew T ; Wunderink, Richard G ; Anderson, Evan J ; Bramley, Anna M ; Jain, Seema ; Williams, Derek J</creator><creatorcontrib>Fritz, Cristin Q ; Edwards, Kathryn M ; Self, Wesley H ; Grijalva, Carlos G ; Zhu, Yuwei ; Arnold, Sandra R ; McCullers, Jonathan A ; Ampofo, Krow ; Pavia, Andrew T ; Wunderink, Richard G ; Anderson, Evan J ; Bramley, Anna M ; Jain, Seema ; Williams, Derek J</creatorcontrib><description>Previous studies examining bacteremia in hospitalized children with pneumonia are limited by incomplete culture data. We sought to determine characteristics of children with bacteremic pneumonia using data from a large prospective study with systematic blood culturing.
Children <18 years hospitalized with pneumonia and enrolled in the multicenter Etiology of Pneumonia in the Community study between January 2010 and June 2012 were eligible. Bivariate comparisons were used to identify factors associated with bacteremia. Associations between bacteremia and clinical outcomes were assessed by using Cox proportional hazards regression for length of stay and logistic regression for ICU admission and invasive mechanical ventilation or shock.
Blood cultures were obtained in 2143 (91%) of 2358 children; 46 (2.2%) had bacteremia. The most common pathogens were
(
= 23, 50%),
(
= 6, 13%), and
(
= 4, 9%). Characteristics associated with bacteremia included male sex, parapneumonic effusion, lack of chest indrawing or wheezing, and no previous receipt of antibiotics. Children with bacteremia had longer lengths of stay (median: 5.8 vs 2.8 days; adjusted hazard ratio: 0.79 [0.73-0.86]) and increased odds of ICU admission (43% vs 21%; adjusted odds ratio: 5.21 [3.82-6.84]) and invasive mechanical ventilation or shock (30% vs 8%; adjusted odds ratio: 5.28 [2.41-11.57]).
Bacteremia was uncommonly detected in this large multicenter cohort of children hospitalized with community-acquired pneumonia but was associated with severe disease.
was detected most often. Blood culture was of low yield in general but may have greater use in those with parapneumonic effusion and ICU admission.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2018-3090</identifier><identifier>PMID: 31217309</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Adolescent ; Analysis ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bacteremia ; Bacteremia - diagnosis ; Bacteremia - epidemiology ; Bacteremia - microbiology ; Bacteremia - therapy ; Bacterial pneumonia ; Blood Culture ; Care and treatment ; Child ; Child, Preschool ; Children ; Community-Acquired Infections - diagnosis ; Community-Acquired Infections - therapy ; Critical Care ; Effusion ; Etiology ; Female ; Health aspects ; Health risk assessment ; Hospital patients ; Hospitalization ; Humans ; Infant ; Length of Stay ; Male ; Mechanical ventilation ; Pediatric research ; Pediatrics ; Pneumonia ; Pneumonia, Bacterial - diagnosis ; Pneumonia, Bacterial - epidemiology ; Pneumonia, Bacterial - microbiology ; Pneumonia, Bacterial - therapy ; Prevalence ; Prevalence studies (Epidemiology) ; Proportional Hazards Models ; Prospective Studies ; Respiration, Artificial ; Risk Factors ; Streptococcus infections ; Streptococcus pneumoniae ; Treatment Outcome ; United States - epidemiology ; Ventilation ; Ventilators ; Wheezing</subject><ispartof>Pediatrics (Evanston), 2019-07, Vol.144 (1), p.1</ispartof><rights>Copyright © 2019 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Jul 2019</rights><rights>Copyright © 2019 by the American Academy of Pediatrics 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-aea1bf8e770fb1fbd296a2737882f2edc468296f213459a3540953a64d4c55bd3</citedby><cites>FETCH-LOGICAL-c522t-aea1bf8e770fb1fbd296a2737882f2edc468296f213459a3540953a64d4c55bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31217309$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fritz, Cristin Q</creatorcontrib><creatorcontrib>Edwards, Kathryn M</creatorcontrib><creatorcontrib>Self, Wesley H</creatorcontrib><creatorcontrib>Grijalva, Carlos G</creatorcontrib><creatorcontrib>Zhu, Yuwei</creatorcontrib><creatorcontrib>Arnold, Sandra R</creatorcontrib><creatorcontrib>McCullers, Jonathan A</creatorcontrib><creatorcontrib>Ampofo, Krow</creatorcontrib><creatorcontrib>Pavia, Andrew T</creatorcontrib><creatorcontrib>Wunderink, Richard G</creatorcontrib><creatorcontrib>Anderson, Evan J</creatorcontrib><creatorcontrib>Bramley, Anna M</creatorcontrib><creatorcontrib>Jain, Seema</creatorcontrib><creatorcontrib>Williams, Derek J</creatorcontrib><title>Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Previous studies examining bacteremia in hospitalized children with pneumonia are limited by incomplete culture data. We sought to determine characteristics of children with bacteremic pneumonia using data from a large prospective study with systematic blood culturing.
Children <18 years hospitalized with pneumonia and enrolled in the multicenter Etiology of Pneumonia in the Community study between January 2010 and June 2012 were eligible. Bivariate comparisons were used to identify factors associated with bacteremia. Associations between bacteremia and clinical outcomes were assessed by using Cox proportional hazards regression for length of stay and logistic regression for ICU admission and invasive mechanical ventilation or shock.
Blood cultures were obtained in 2143 (91%) of 2358 children; 46 (2.2%) had bacteremia. The most common pathogens were
(
= 23, 50%),
(
= 6, 13%), and
(
= 4, 9%). Characteristics associated with bacteremia included male sex, parapneumonic effusion, lack of chest indrawing or wheezing, and no previous receipt of antibiotics. Children with bacteremia had longer lengths of stay (median: 5.8 vs 2.8 days; adjusted hazard ratio: 0.79 [0.73-0.86]) and increased odds of ICU admission (43% vs 21%; adjusted odds ratio: 5.21 [3.82-6.84]) and invasive mechanical ventilation or shock (30% vs 8%; adjusted odds ratio: 5.28 [2.41-11.57]).
Bacteremia was uncommonly detected in this large multicenter cohort of children hospitalized with community-acquired pneumonia but was associated with severe disease.
was detected most often. Blood culture was of low yield in general but may have greater use in those with parapneumonic effusion and ICU admission.</description><subject>Adolescent</subject><subject>Analysis</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Bacteremia</subject><subject>Bacteremia - diagnosis</subject><subject>Bacteremia - epidemiology</subject><subject>Bacteremia - microbiology</subject><subject>Bacteremia - therapy</subject><subject>Bacterial pneumonia</subject><subject>Blood Culture</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Community-Acquired Infections - diagnosis</subject><subject>Community-Acquired Infections - therapy</subject><subject>Critical Care</subject><subject>Effusion</subject><subject>Etiology</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Hospital patients</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Infant</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Pediatric research</subject><subject>Pediatrics</subject><subject>Pneumonia</subject><subject>Pneumonia, Bacterial - diagnosis</subject><subject>Pneumonia, Bacterial - epidemiology</subject><subject>Pneumonia, Bacterial - microbiology</subject><subject>Pneumonia, Bacterial - therapy</subject><subject>Prevalence</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial</subject><subject>Risk Factors</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><subject>Ventilation</subject><subject>Ventilators</subject><subject>Wheezing</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1P3DAQxa0KVLa01x4rS1x6IIs_4-SCtF2VFoS0qGrPluNMFkNiL3aC2v--jpaiwmmkmd88zZuH0EdKllQKdraDNi0ZoVXBSU3eoAUldVUIpuQBWhDCaSEIkUfoXUp3hBAhFXuLjjhlVOWFBbq6ifBoevAWTvEPl-7xhbFjiOkUG9_izTTaMEDCocNf8gAiDM7iGw_TELwz2Hm8vnV9G8G_R4ed6RN8eKrH6NfF15_r78X15tvlenVdWMnYWBgwtOkqUIp0De2altWlYYqrqmIdg9aKssqtjlEuZG24FKSW3JSiFVbKpuXH6Hyvu5uaIfPgx2h6vYtuMPGPDsbplxPvbvU2POqypFLSMgt8fhKI4WGCNOrBJQt9bzyEKWnGhKCc0opn9OQVehem6LO9TMlKcaHETBV7aps_qZ23wY_wO3-u72ELOrtfb_RK1qxkSlCZ-eWetzGkFKF7Pp4SPceq51j1HKueY80Ln_63_Iz_y5H_BfO4nIg</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Fritz, Cristin Q</creator><creator>Edwards, Kathryn M</creator><creator>Self, Wesley H</creator><creator>Grijalva, Carlos G</creator><creator>Zhu, Yuwei</creator><creator>Arnold, Sandra R</creator><creator>McCullers, Jonathan A</creator><creator>Ampofo, Krow</creator><creator>Pavia, Andrew T</creator><creator>Wunderink, Richard G</creator><creator>Anderson, Evan J</creator><creator>Bramley, Anna M</creator><creator>Jain, Seema</creator><creator>Williams, Derek J</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190701</creationdate><title>Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children</title><author>Fritz, Cristin Q ; Edwards, Kathryn M ; Self, Wesley H ; Grijalva, Carlos G ; Zhu, Yuwei ; Arnold, Sandra R ; McCullers, Jonathan A ; Ampofo, Krow ; Pavia, Andrew T ; Wunderink, Richard G ; Anderson, Evan J ; Bramley, Anna M ; Jain, Seema ; Williams, Derek J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-aea1bf8e770fb1fbd296a2737882f2edc468296f213459a3540953a64d4c55bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Analysis</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Bacteremia</topic><topic>Bacteremia - diagnosis</topic><topic>Bacteremia - epidemiology</topic><topic>Bacteremia - microbiology</topic><topic>Bacteremia - therapy</topic><topic>Bacterial pneumonia</topic><topic>Blood Culture</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Community-Acquired Infections - diagnosis</topic><topic>Community-Acquired Infections - therapy</topic><topic>Critical Care</topic><topic>Effusion</topic><topic>Etiology</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health risk assessment</topic><topic>Hospital patients</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Infant</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Pediatric research</topic><topic>Pediatrics</topic><topic>Pneumonia</topic><topic>Pneumonia, Bacterial - diagnosis</topic><topic>Pneumonia, Bacterial - epidemiology</topic><topic>Pneumonia, Bacterial - microbiology</topic><topic>Pneumonia, Bacterial - therapy</topic><topic>Prevalence</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial</topic><topic>Risk Factors</topic><topic>Streptococcus infections</topic><topic>Streptococcus pneumoniae</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><topic>Ventilation</topic><topic>Ventilators</topic><topic>Wheezing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fritz, Cristin Q</creatorcontrib><creatorcontrib>Edwards, Kathryn M</creatorcontrib><creatorcontrib>Self, Wesley H</creatorcontrib><creatorcontrib>Grijalva, Carlos G</creatorcontrib><creatorcontrib>Zhu, Yuwei</creatorcontrib><creatorcontrib>Arnold, Sandra R</creatorcontrib><creatorcontrib>McCullers, Jonathan A</creatorcontrib><creatorcontrib>Ampofo, Krow</creatorcontrib><creatorcontrib>Pavia, Andrew T</creatorcontrib><creatorcontrib>Wunderink, Richard G</creatorcontrib><creatorcontrib>Anderson, Evan J</creatorcontrib><creatorcontrib>Bramley, Anna M</creatorcontrib><creatorcontrib>Jain, Seema</creatorcontrib><creatorcontrib>Williams, Derek J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fritz, Cristin Q</au><au>Edwards, Kathryn M</au><au>Self, Wesley H</au><au>Grijalva, Carlos G</au><au>Zhu, Yuwei</au><au>Arnold, Sandra R</au><au>McCullers, Jonathan A</au><au>Ampofo, Krow</au><au>Pavia, Andrew T</au><au>Wunderink, Richard G</au><au>Anderson, Evan J</au><au>Bramley, Anna M</au><au>Jain, Seema</au><au>Williams, Derek J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>144</volume><issue>1</issue><spage>1</spage><pages>1-</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>Previous studies examining bacteremia in hospitalized children with pneumonia are limited by incomplete culture data. We sought to determine characteristics of children with bacteremic pneumonia using data from a large prospective study with systematic blood culturing.
Children <18 years hospitalized with pneumonia and enrolled in the multicenter Etiology of Pneumonia in the Community study between January 2010 and June 2012 were eligible. Bivariate comparisons were used to identify factors associated with bacteremia. Associations between bacteremia and clinical outcomes were assessed by using Cox proportional hazards regression for length of stay and logistic regression for ICU admission and invasive mechanical ventilation or shock.
Blood cultures were obtained in 2143 (91%) of 2358 children; 46 (2.2%) had bacteremia. The most common pathogens were
(
= 23, 50%),
(
= 6, 13%), and
(
= 4, 9%). Characteristics associated with bacteremia included male sex, parapneumonic effusion, lack of chest indrawing or wheezing, and no previous receipt of antibiotics. Children with bacteremia had longer lengths of stay (median: 5.8 vs 2.8 days; adjusted hazard ratio: 0.79 [0.73-0.86]) and increased odds of ICU admission (43% vs 21%; adjusted odds ratio: 5.21 [3.82-6.84]) and invasive mechanical ventilation or shock (30% vs 8%; adjusted odds ratio: 5.28 [2.41-11.57]).
Bacteremia was uncommonly detected in this large multicenter cohort of children hospitalized with community-acquired pneumonia but was associated with severe disease.
was detected most often. Blood culture was of low yield in general but may have greater use in those with parapneumonic effusion and ICU admission.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>31217309</pmid><doi>10.1542/peds.2018-3090</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Pediatrics (Evanston), 2019-07, Vol.144 (1), p.1 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adolescent Analysis Anti-Bacterial Agents - therapeutic use Antibiotics Bacteremia Bacteremia - diagnosis Bacteremia - epidemiology Bacteremia - microbiology Bacteremia - therapy Bacterial pneumonia Blood Culture Care and treatment Child Child, Preschool Children Community-Acquired Infections - diagnosis Community-Acquired Infections - therapy Critical Care Effusion Etiology Female Health aspects Health risk assessment Hospital patients Hospitalization Humans Infant Length of Stay Male Mechanical ventilation Pediatric research Pediatrics Pneumonia Pneumonia, Bacterial - diagnosis Pneumonia, Bacterial - epidemiology Pneumonia, Bacterial - microbiology Pneumonia, Bacterial - therapy Prevalence Prevalence studies (Epidemiology) Proportional Hazards Models Prospective Studies Respiration, Artificial Risk Factors Streptococcus infections Streptococcus pneumoniae Treatment Outcome United States - epidemiology Ventilation Ventilators Wheezing |
| title | Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children |
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