Escherichia coli bacteremia in children. A review of 91 cases in 10 years
W. A. Bonadio, D. S. Smith, E. Madagame, J. Machi and N. Kini
Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee.
We reviewed 91 cases of pediatric Escherichia coli bacteremia during a
10-year period. Thirty one patients were afebrile; a significantly greater
proportion of these patients were aged less than 1 month, had
ampicillin-resistant E coli isolates, or had persistent bacteremia 24 hours
after initiating antibiotic therapy. Infection was community acquired in 65
cases; associated urinary tract infection was six times more common in this
setting than in nosocomially acquired infections. In 85 cases at least 1
underlying medical condition/focus of infection was identified at the time
the positive blood culture was obtained, the most common were immune
deficiency states (38 cases), urinary tract infection (29 cases), and
lesions of the gastrointestinal tract (27 cases). Polymicrobial bacteremia
occurred in five cases. Twelve patients died; significantly associated with
death were hypotension requiring pressor therapy, presence of a central
venous catheter, and neutropenia.
