Er Jeremy, Wallis Peter, Maloney Samuel, Norton Robert
Townsville Hospital, Townsville, Queensland, Australia.
J Paediatr Child Health. 2015 Apr;51(4):437-42. doi: 10.1111/jpc.12750. Epub 2014 Oct 15.
Bacteraemias in children are an important cause of morbidity and mortality. Knowledge of local epidemiology and trends is important to inform practitioners of likely pathogens in the sick child. This study aimed to determine trends over time in pathogenic organisms causing paediatric bacteraemia in North Queensland and to audit a hospital's blood culture results with respect to contamination rate.
This was a retrospective review of 8385 blood cultures collected from children attending a tertiary centre in North Queensland over a 10-year period (2001-2010).
There were 696 positive blood cultures (8.3%) with 70 different bacterial species detected. Gram-positive and Gram-negative bacteria accounted for 48.6% and 51.4% of isolates, respectively. Overall, bacteraemia accounted for 4.7 per 1000 admissions. The rate of contamination was 60.6% among positive blood cultures and 5.0% for all blood cultures sampled. These results were compared with previous published reports. Notable differences were seen in the frequencies of Salmonella and group A Streptococcus bacteraemias in North Queensland when compared with other reports. There was also a decline in vaccine-preventable infections such as S. pneumoniae and an increasing trend of community-acquired MRSA bacteraemia.
This study has demonstrated the unique profile of causative pathogens of paediatric bacteraemias in tropical Australia. In light of the increasing prevalence of MRSA, empiric treatment for sepsis for children in this region needs to be reconsidered.
儿童菌血症是发病和死亡的重要原因。了解当地的流行病学情况和趋势对于告知从业者患病儿童可能的病原体很重要。本研究旨在确定北昆士兰地区引起小儿菌血症的致病生物体随时间的变化趋势，并审核一家医院血培养结果的污染率。
这是一项对在10年期间（2001 - 2010年）从北昆士兰一家三级中心就诊的儿童采集的8385份血培养样本进行的回顾性研究。
共696份血培养呈阳性（8.3%），检测到70种不同的细菌种类。革兰氏阳性菌和革兰氏阴性菌分别占分离菌株的48.6%和51.4%。总体而言，菌血症占每1000例入院病例的4.7例。阳性血培养中的污染率为60.6%，所有采样血培养的污染率为5.0%。将这些结果与之前发表的报告进行了比较。与其他报告相比，北昆士兰地区沙门氏菌和A组链球菌菌血症的发生率存在显著差异。此外，可通过疫苗预防的感染（如肺炎链球菌）有所下降，而社区获得性耐甲氧西林金黄色葡萄球菌菌血症呈上升趋势。
本研究揭示了澳大利亚热带地区小儿菌血症致病病原体的独特情况。鉴于耐甲氧西林金黄色葡萄球菌的患病率不断上升，该地区儿童脓毒症的经验性治疗需要重新考虑。
