From the Pediatric Infectious Disease Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Pediatr Infect Dis J. 2013 Nov;32(11):e414-8. doi: 10.1097/INF.0b013e31829baae0.
Campylobacter, a common cause of childhood gastroenteritis, rarely causes bacteremia, which is reported mainly in immune-compromised children. Our aim was to compare demographic and clinical characteristics of childhood campylobacter bacteremia (CB) between children with and without risk factors for CB.
A retrospective, population-based study, conducted between 1989 and 2010. Risk factors were defined as immunodeficiency, malignancy, extreme prematurity or chronic diseases with malnutrition.
Seventy-six CB episodes (1 per child/month) were identified in 14 children with risk factors (30 episodes) and 46 children without risk factors (46 episodes). Children with risk factors were older (mean age 120.0±72.8 vs. 16.2±27.6 months) with higher proportion of males (90.0% vs. 60.9%), less gastrointestinal symptoms (43.3% vs. 69.9%) and higher hospitalization rates (96.7% vs. 69.6%) compared with children without risk factors. Campylobacter jejuni and Campylobacter coli (46/47 of identified species) were the most common species in both groups. Positive campylobacter stool cultures were found only in children without risk factors (0% vs. 38.5%). No mortality cases were observed. All isolates tested for antibiotic susceptibility were sensitive to macrolides and carbapenems.
Childhood CB is rare in southern Israel. The disease manifests as a single gastroenteritis complication in a previously healthy young child or as recurrent episodes in an older, immune-compromised child, usually without gastrointestinal symptoms. This disparity may reflect pathogenesis differences, with disease in the immune-competent being dependent on pathogen virulence, whereas disease in the immune-compromised being host dependent. Disease outcome is usually favorable, and macrolides remain the antibiotic treatment of choice.
空肠弯曲菌是儿童肠胃炎的常见病因，很少引起菌血症，主要见于免疫功能低下的儿童。我们的目的是比较有和无空肠弯曲菌菌血症（CB）危险因素的儿童的临床和人口统计学特征。
这是一项在 1989 年至 2010 年期间进行的回顾性、基于人群的研究。危险因素定义为免疫缺陷、恶性肿瘤、极早产或伴有营养不良的慢性疾病。
在 14 名有危险因素的儿童（30 例）和 46 名无危险因素的儿童（46 例）中发现 76 例 CB 发作。有危险因素的儿童年龄较大（平均年龄 120.0±72.8 与 16.2±27.6 个月），男性比例较高（90.0%与 60.9%），胃肠道症状较少（43.3%与 69.9%），住院率较高（96.7%与 69.6%）。与无危险因素的儿童相比，两组均以空肠弯曲菌和大肠弯曲菌（47 株鉴定的种中 46 株）最为常见。仅在无危险因素的儿童中发现空肠弯曲菌粪便培养阳性（0%与 38.5%）。未观察到死亡病例。所有分离株的抗生素敏感性试验均对大环内酯类和碳青霉烯类敏感。
在以色列南部，儿童 CB 很少见。这种疾病表现为先前健康的幼儿出现单一的肠胃炎并发症，或年龄较大的免疫功能低下的幼儿出现反复发作，通常无胃肠道症状。这种差异可能反映了发病机制的不同，免疫功能正常者的疾病依赖于病原体的毒力，而免疫功能低下者的疾病则依赖于宿主。疾病的结局通常是有利的，大环内酯类仍然是治疗的首选抗生素。
