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Rate of bloodstream infections among US kids stabilizes
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Bloodstream infection rates have remained relatively consistent in the United States over the past decade, with most acquired in the community, according to an analysis of nearly 2 million inpatient encounters with children published in Clinical Infectious Diseases.
“It is unclear if both [community-acquired infections (CAIs)] and [hospital-acquired infections (HAIs)] are decreasing, and what impacts each of these rates is having on the rates of [bloodstream infections (BSIs)] in children,” Alicen B. Spaulding, PhD, MPH, a scientific investigator at Children’s Minnesota, and colleagues wrote. “Knowing which pathogens are causing BSIs is important for informing empiric antimicrobial therapy guidelines, tracking resistance patterns and targeting infection prevention strategies.”
The researchers identified 1,809,751 inpatient encounters with patients aged younger than 19 years between 2009 and 2016 in 162 hospitals in the U.S. BSIs were observed in 0.3% of patients. CAIs were reported most frequently (50%), they said, followed BSIs in neonates (43%) and HAIs (7%). Compared with patients who did not have BSIs, those who were infected were more likely to be aged 1 to 5 years and have a complex chronic condition or central line.
The researchers did not observe a significant decline in hospitalizations due to BSIs (3.13 per 1,000 admissions in 2009 to 2.98 per 1,000 admissions in 2016).
Although a significant increase in the rate of Escherichia coli (0.80 to 1.26), methicillin-sensitive Staphylococcus aureus (0.83 to 1.98) and group A streptococcus (0.16 to 0.37) were identified among age groups other than neonates, the rate of BSIs caused by Streptococcus pneumoniae (1.07 to 0.26) and Enterococcus species (0.60 to 0.17) decreased.
According to the researchers, some regional differences were observed in the prevalence of bacteria that cause BSIs. The greatest differences were seen for E. coli, with the higher rates observed in New England and the South Atlantic regions.
“Although a significant amount of time and attention is dedicated to newborn infections and HAIs, we found that most infections were CAIs and occurred among non-neonates, indicating that future prevention efforts should consider focusing on these populations in particular,” Spaulding and colleagues wrote. – by Katherine Bortz
Disclosures : Spaulding reports no relevant financial disclosures. Please see the study for a list of all other authors’ relevant financial disclosures.
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