Risk factors of bacteremia in children hospitalized with community-acquired pneumonia: A nested case-control study |
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| Authors: | Shogo Akahoshi Yoshihiko Morikawa Hiroshi Sakakibara Tetsuji Kaneko Asami Sekine Toshimasa Obonai Hiroshi Hataya |
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| Affiliation: | 1. Department of General Pediatrics, Tokyo Metropolitan Children’s Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan;2. Clinical Research Support Center, Tokyo Metropolitan Children’s Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan;3. Department of Pediatrics, Tama-Hokubu Medical Center, Tokyo Metropolitan Health and Medical Treatment Corporation, 1 Chome-7-1 Aobacho, Higashimurayama, Tokyo, 189-8511, Japan;1. Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan;2. Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan;1. Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, South Korea;2. Department of Infectious Diseases, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea;3. Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea;1. Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Department of Infectious Disease and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Infectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;4. Anesthesia and Critical Care Department, Anesthesiology Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;5. Department of Clinical Pharmacy, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;6. Department of Anesthesiology and Critical Care, Faculty of Medicine, Shohadaye – Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;7. Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;8. Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran;9. Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, 2?34?10, Ebisu, Shibuya-ku, 150-0013, Tokyo, Japan;2. Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6?20?2, Shinkawa, Mitaka-shi, 181-8611, Tokyo, Japan;3. Department of Pediatrics, Tokyo Metropolitan Hiroo Hospital, 2?34?10, Ebisu, Shibuya-ku, 150-0013, Tokyo, Japan;4. Department of Infectious Diseases, Tokyo Metropolitan Hiroo Hospital, 2?34?10, Ebisu, Shibuya-ku, 150-0013, Tokyo, Japan;5. Department of Pulmonary Medicine, Tokyo Metropolitan Hiroo Hospital, 2?34?10, Ebisu, Shibuya-ku, 150-0013, Tokyo, Japan;6. Tokyo Metropolitan Hiroo Hospital, 2?34?10, Ebisu, Shibuya-ku, 150-0013, Tokyo, Japan |
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| Abstract: | ObjectiveTo assess the risk factors of bacteremia in children hospitalized with community-acquired pneumonia (CAP).Study designThe present, nested, case-control study enrolled a cohort of patients with CAP aged < 18 years who were hospitalized at Tokyo Metropolitan Children’s Medical Center or Tama-Hokubu Medical Center between March 2010 and February 2018. Among the cohort with blood cultures (BCs), patients with bacteremia were identified and matched with five control patients based on their treatment facility, underlying disease, and age. Conditional logistic regression was used to calculate the odds ratios (ORs) of bacteremia for risk factor candidates.ResultsBCs were obtained for 2,383 (84%) of the 2,853 patients in the CAP cohort. Of those with BCs, 34 (1.4%) had bacteremia. S. pneumoniae and H. influenzae accounted for 26 (76%) and four (12%) instances of the bacteremia pathogens, respectively. Bacteremia occurred more frequently among patients hospitalized in the spring than during other seasons (P = 0.022). On multivariate analysis, the severity of pneumonia was not associated with bacteremia incidence (OR: 0.92 [0.30–2.85]) while a white blood cell count > 16,000/μL (OR: 5.90 [2.14–16.3]) was shown to be a significant risk factor. The OR of the need for a ventilator on admission day was significantly high (28.4 [3.02–1374]) on univariate analysis, but the subject pool was too small to determine its significance on multivariate analysis.ConclusionsThe results of the present study supported BC collection in patients with leukocytosis and in those requiring ventilator use on admission. |
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| Keywords: | Community-acquired pneumonia Bacteremia Blood culture Children |
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