Spectrum of 2,836 Cases of Invasive Bacterial or Fungal Infections in Children: Results of Prospective Nationwide Five-Year Surveillance in Finland

Saarinen, Merja; Takala, Aino K.; Koskenniemi, Eeva; Kela, Eija; Rönnberg, Pirjo-Riitta; Pekkanen, Eeva; Kiiski, Pirjo; Eskola, Juhani

doi:10.1093/clinids/21.5.1134

Cited by 34 publications

(25 citation statements)

References 29 publications

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“…Approximately 90% of invasive H. influenzae disease and 75% of invasive S. pneumoniae disease were seen in children less than one year of age. This is at a clearly lower age than in developed countries, 26 but is consistent with previous findings from developing countries. 8 The fact that one-third of invasive pneumococcal and half of H. influenzae infections occurred during the first six months of life sets stringent requirements on early vaccination, if the new conjugate vaccines against these pathogens are to be used to prevent these diseases in developing countries.…”

Section: -25supporting

confidence: 92%

Invasive bacterial infections of children in a rural province in the central Philippines.

Lupisan¹,

Herva²,

Sombrero³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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Abstract. The etiology of invasive bacterial infections was studied among 956 Filipino children less than five years old who fulfilled the World Health Organization criteria for severe or very severe pneumonia or had suspected meningitis or sepsis. The most common invasive infections were due to Streptococcus pneumoniae (12 [1.3%]) and Haemophilus influenzae (12 [1.3%]); including four cases of pneumococcal meningitis and 11 cases of H. influenzae meningitis. Type 1 was the most common (six of the 12 isolates) of the pneumococcal serotypes. Serotypes/groups 1, 6, 14, and 23 accounted for 91.7% of the invasive isolates. The majority of the H. influenzae strains from blood (10 out of 10) and cerebrospinal fluid (6 out of 7) were type b. Almost all of the invasive S. pneumoniae (9 out of 12) and H. influenzae (11 out of 12) infections were seen before one year of age, which stresses the need to investigate early immunization of children for H. influenzae type b and S. pneumoniae, as well as maternal immunization to maximize the potential of immunoprophylaxis.

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Section: -25supporting

confidence: 92%

Invasive bacterial infections of children in a rural province in the central Philippines.

Lupisan¹,

Herva²,

Sombrero³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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“…Polymicrobial bacteremias account for 5 to 20% of all bloodstream infections, with most cases linked to patients with underlying conditions (17)(18)(19)(20). Similarly, 7.9% (16/203) of all positive blood cultures collected from pediatric patients ranging from 5 months to 16 years of age in this study were polymicrobial, with 56.3% (9/16) of the mixed cultures from BacT/Alert PF bottles (Table 2).…”

mentioning

confidence: 62%

“…However, the clinical significance of polymicrobial bacteremias and importance of identifying these cases in pediatric patients were highlighted in a previous study that demonstrated higher rates of polymicrobial bloodstream infections among children Ͻ1 year of age than in older children and an increase in overall case fatality rate from 4.1% to 7.4% (20). In this study, the BC-GP assay was able to successfully detect as least one organism from polymicrobial blood cultures in 93.8% of cases and correctly identify all bacterial targets and resistance markers in 81.3% of cases.…”

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confidence: 99%

Performance of the Verigene Gram-Positive Blood Culture Assay for Direct Detection of Gram-Positive Organisms and Resistance Markers in a Pediatric Hospital

et al. 2014

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The performance characteristics of the Verigene Gram-positive blood culture (BC-GP) assay were evaluated in pediatric patients. Concordance of the BC-GP assay was 95.8%, with significant decreases in turnaround time for identification and resistance detection. BC-GP is highly accurate and can be integrated into the routine workflow of the microbiology laboratory. Bloodstream infections are one of the leading causes of death in the United States, and prompt initiation of appropriate antimicrobial therapy is essential to significantly improve patient management and reduce the rate of mortality of bacteremic patients (1). Gram-positive pathogens are implicated in Ͼ50% of all bacterial bloodstream infections, with coagulase-negative staphylococci (CoNS) being the most common Gram-positive bacteria isolated from blood culture, followed by Staphylococcus aureus and Enterococcus spp. (2-4). Similar findings have been demonstrated in our institution where approximately 64% of all positive blood cultures consist of Gram-positive organisms. The workup of pathogens in the clinical microbiology laboratory is a key contributing factor in overall mortality rate, as delays in identification and susceptibility testing have been demonstrated to directly impact patient survival (5). Previous studies have been fundamental in directly correlating rapid identification of Gram-positive pathogens with improved patient outcome, decreased hospital length of stay, and decreased hospital costs (6-9). Moreover, direct detection of the mecA gene in methicillin-resistant S. aureus (MRSA) has been demonstrated to be an effective tool for managing vancomycin usage as well as reducing both hospital length of stay and costs (10, 11).The Verigene Gram-positive blood culture (BC-GP) assay (Nanosphere Inc., Northbrook, IL) is a microarray-based, multiplexed, molecular assay approved by the Food and Drug Administration (FDA) for rapid detection and identification of 12 Gram-positive targets (S. aureus, Staphylococcus epidermidis, Staphylococcus lugdunensis, Staphylococcus spp., Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus group, Streptococcus pneumoniae, Streptococcus spp., Enterococcus faecium, Enterococcus faecalis, Listeria monocytogenes) and 3 resistance markers (mecA, vanA, vanB). Four recent studies have evaluated the performance of the BC-GP assay on different bottle types (12-15). Specifically, Sullivan et al. reported high sensitivity and specificity in pediatric patients using BacT/Alert pediatric FAN (PF) blood cultures (14). This study evaluated the performance characteristics of the BacT/Alert standard aerobic (SA) noncharcoal and PF charcoal blood culture bottles collected from pediatric patients admitted to Children's Hospital Los Angeles (CHLA), a freestanding pediatric tertiary care center. The implementation process and comparison of workflow and turnaround time (TAT) were also assessed. A total of 203 positive blood cultures (104 SA, 99 PF) from 203 pediatric patients submitted for routine workup to th...

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“…[9][10][11] Vaccination studies have also provided reliable epidemiologic data on the incidence and other aspects of invasive bacterial infections. 12 On the other hand, reliable data on the occurrence of invasive infections have provided possibilities for retrospective analysis of the effectiveness of penicillin in bacteremic pneumococcal pneumonia 13 or vaccination against typhoid fever, 14 and may be necessary for defining the size of disease burden (e.g., H. influenzae type b) for the introduction of new intervention programs.…”

Section: Discussionmentioning

confidence: 99%

“…During these eight months, 156 blood cultures were done with isolations of Salmonella sp. (3), Staphylococcus aureus (11), Escherichia coli (3), other Enterobacteriaceae (4), non-fermenting Gram-negative rods (4), alpha-hemolytic streptococcus (12), and coagulase-negative staphylococcus (12). During the same period, 28 CSF specimens were cultured, with one yielding presumed S. pneumoniae, and another yielding coagulase-negative staphylococcus.…”

Section: Impact Of the Arivac Laboratory On Bacteriologic Findings Atmentioning

confidence: 99%

Establishing a laboratory for surveillance of invasive bacterial infections in a tertiary care government hospital in a rural province in the Philippines.

Herva

Sombrero²,

Lupisan³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. A clinical bacteriologic laboratory was established in a tertiary care government hospital in The Philippines, where expert bacteriologic laboratories do not usually exist at this level of health care. The laboratory was jointly established by the Research Institute for Tropical Medicine (RITM) (Manila, The Philippines) and the National Public Health Institute (KTL) (Helsinki, Finland). The laboratory was planned, its personnel were trained, and its functioning was continuously supported by the RITM and KTL. The following aspects were of utmost importance in establishing the laboratory and launching its work: 1) the support of the RITM bacteriologic laboratory, with backup and consultations from KTL; 2) creation and maintenance of personal contacts between clinicians and laboratory staff with an emphasis on clinical relevance and rapid reporting of laboratory results; 3) the consideration of the quality aspects of the work from the start; and 4) keen follow-up of the bacteriologic results and their clinical significance and use, of practical laboratory work, and of quality assurance aspects. In the first two years of its operation, the laboratory identified Streptococcus pneumoniae and Haemophilus influenzae as the most important causes of severe pneumonia, sepsis or meningitis in children less than two years of age, and Salmonella typhi as the most frequent significant isolate from the blood cultures, being found most often in school age children and young adults.

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Spectrum of 2,836 Cases of Invasive Bacterial or Fungal Infections in Children: Results of Prospective Nationwide Five-Year Surveillance in Finland

Cited by 34 publications

References 29 publications

Invasive bacterial infections of children in a rural province in the central Philippines.

Invasive bacterial infections of children in a rural province in the central Philippines.

Performance of the Verigene Gram-Positive Blood Culture Assay for Direct Detection of Gram-Positive Organisms and Resistance Markers in a Pediatric Hospital

Establishing a laboratory for surveillance of invasive bacterial infections in a tertiary care government hospital in a rural province in the Philippines.

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