Klebsiella pneumoniae bacteremia in children. Fifty-seven cases in 10 years
W. A. Bonadio
Medical College of Wisconsin, Children's Hospital, Milwaukee.
A review was performed of the 57 cases of Klebsiella pneumoniae bacteremia
that occurred in children at our institution during a 10-year period. The
rate of K pneumoniae bacteremia relative to all blood cultures in which
bacteria were isolated was 1.1%. Children younger than 12 months of age
accounted for 38 cases (67%). There were 8 children (14%) who were afebrile
at the time bacteremia was documented; other presenting clinical features
were generally indistinguishable from those that characterize pediatric
bacteremia of more common causes. Fourteen children (25%) were receiving
broad-spectrum parenteral antibiotic therapy at the time bacteremia was
documented. In 53 patients (93%), an underlying condition predisposing to
opportunistic infection was identified, the most common of which were
lesions of the gastrointestinal tract (56%), presence of an indwelling
central venous catheter (35%), and neutropenia (25%). Klebsiella pneumoniae
was a constituent of polymicrobial bacteremia in 15 patients (26%). The
overall mortality rate associated with this infection was 20%, with over
one half of all deaths occurring in infants who were afebrile at the time
bacteremia was documented. Klebsiella pneumoniae bacteremia is a relatively
uncommon, serious infection that usually occurs in young children with
predisposing underlying conditions, and is associated with a significant
mortality rate.
