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The aetiology of paediatric bloodstream infections changes after pneumococcal vaccination and group B streptococcus prophylaxis
Author(s) -
Luthander Joachim,
Bennet Rutger,
Giske Christian G.,
Nilsson Anna,
Eriksson Margareta
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13070
Subject(s) - medicine , streptococcus pneumoniae , incidence (geometry) , vaccination , sepsis , group b , meningitis , streptococcus , staphylococcus aureus , antibiotics , etiology , streptococcus agalactiae , antibiotic resistance , bacteremia , antibiotic prophylaxis , immunology , pediatrics , microbiology and biotechnology , bacteria , biology , physics , genetics , optics
Aim This study explored the incidence and aetiology of bloodstream infections after patients received the pneumococcal conjugate vaccination and a risk‐based intrapartum antibiotic prophylaxis against early onset sepsis caused by group B streptococcus . We also monitored clinically relevant antimicrobial resistance. Method We studied 3986 positive blood cultures from children up to 17 years of age at a paediatric hospital in Stockholm, Sweden, using data from medical records before and after the initiatives, to reduce early onset sepsis, were introduced in 2007 and 2008. Results Bloodstream infections caused by Streptococcus pneumoniae declined by 42% overall (5.6 to 3.2/100 000) and by 62% in previously healthy children under 36 months of age (24.2 to 9.2/100 000). Early onset sepsis caused by group B streptococcus declined by 60% (0.5 to 0.2/1000 live born children). Bacterial meningitis caused by these bacteria decreased by 70%. Staphylococcus aureus and various Gram‐negative bacteria became the dominant pathogens, in both previously healthy children and those with underlying disease. Overall, antimicrobial resistance remained low between the two 5‐year study periods. Conclusion Pneumococcal conjugate vaccination and risk‐based intrapartum antibiotic prophylaxis against group B streptococcus effectively decreased the incidence of bloodstream infections. Empirical antibiotic therapy should target Staphylococcus aureus in both community and hospital‐acquired invasive bacterial infections.