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Paediatric Escherichia coli bacteraemia presentations and high‐risk factors in the emergency department
Author(s) -
Elgoibar Borja,
Gangoiti Iker,
GarciaGarcia Juan José,
HernandezBou Susanna,
Gomez Borja,
Martinez Indart Lorea,
Mintegi Santiago
Publication year - 2021
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.15549
Subject(s) - medicine , emergency department , bacteremia , confidence interval , pediatrics , prospective cohort study , urinary system , antibiotics , microbiology and biotechnology , psychiatry , biology
Aim Escherichia coli ( E coli ) is a known cause of paediatric bacteraemia. The main objective was to characterise the emergency department (ED) presentations of paediatric E coli bacteraemia and secondarily to identify those related to greater severity. Methods This was a sub‐study of a multicentre cross‐sectional prospective registry including all with E coli bacteraemia episodes between 2011 and 2016. We used multiple correspondence and cluster analysis to identify different patterns. Results We included 291 patients and 43 met criteria for severe disease (14.3%, 95% confidence interval 11.2‐19.3). We identified four types of paediatric E coli bacteraemia presentations. Two (178 patients, 61.2%) were related to well‐appearing previously healthy infants with associated urinary tract infection (UTI). Well‐appearing children older than 12 months old with underlying disease (n = 60, 20.6%) and non‐well‐appearing children of different ages (n = 53, 18.2%) corresponded to the other two types; these had associated UTI infrequently and higher severity rate (15% and 50.9%, respectively, higher when compared with the two previous types, P < .01), including the two patients who died. Conclusion There were four different types of ED paediatric E coli bacteraemia presentations with different severity. Febrile young children with associated UTI showed the best outcome.