Polymicrobial bacteremia in children. An 11-year experience
W. A. Bonadio
Department of Pediatrics, Medical College of Wisconsin, Milwaukee.
The clinical records of all patients with blood cultures positive for a
bacterial pathogen were retrospectively examined during an 11-year period
to determine the rate of and clinical features associated with
polymicrobial bacteremia. During this period, bacteria were isolated in
6302 blood cultures. Of these cultures, 38 instances (0.6%) of
polymicrobial bacteremia occurred in 38 patients. In 37 patients (97%), an
underlying condition was identified that was considered a predisposing
factor for polymicrobial bacteremia--18 patients (42%) had lesions of the
gastrointestinal tract, 13 patients (34%) had an indwelling central venous
catheter, nine patients (24%) had a malignant neoplasm or were receiving
chemotherapy, and nine patients (24%) had neutropenia. A total of 98
pathogenic organisms were isolated; 52 were gram-negative and 46 were
gram-positive, and 18 patients (47%) had more than two organisms isolated.
Polymicrobial bacteremia was usually clinically indistinguishable from
monomicrobial septicemia. Overall mortality was 32%. Polymicrobial
bacteremia continues to be a rare, but serious, infectious disease that
usually affects children with underlying medical problems and is associated
with a high rate of mortality.
