Culture-proven Bloodstream Infections at a Specialist Pediatric Hospital

Laila S Al Yazidi, Alexander C Outhred, Philip N Britton, Alison Kesson

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2 Citations (Scopus)


BACKGROUND: Bloodstream infection (BSI) is one of the leading causes of morbidity and mortality in children. This study was done to assess the local epidemiology and outcome of BSIs managed at a large specialist pediatric hospital with a focus on community-onset BSI.

METHODS: We retrospectively reviewed laboratory-confirmed BSI in children (0-18 years) at The Children's Hospital at Westmead over a 3-year period (2014-2016). Laboratory data and patient medical records were used to determine BSI rates, blood culture contamination rates, patient demographics, isolate profile, antimicrobial resistance and mortality rate in this cohort.

RESULTS: In total, 47,368 blood cultures were collected; 1027 (2.2%) grew probable contaminants and 991 (2.1%) grew clinically significant isolates. Clinically significant bacteremia accounted for 4.8 per 1000 admissions, with 391 children managed for 465 culture-proven BSI episodes. One hundred thirty-one (28.2%) episodes were community-onset community-associated, and 334 (71.8%) were either community-onset healthcare-associated (HCA) (187; 40.2 %) or hospital-onset (147; 31.6%). Of the significant isolates, 243 (52.3%) were Gram-positive bacteria, 198 (42.6%) were Gram-negative bacteria, 6 (1.3%) were polymicrobial infections and 18 (3.9%) were yeast. Staphylococcus aureus (115; 24.7%) and Escherichia coli (54; 11.6%) were the most common organisms identified. Osteoarticular infection (44; 33.6%) and urosepsis (23; 17.6%) were the most frequent sites of infection associated with non-HCA BSI. Mortality at 30 days was reported in 15 (3.3%) children, all whom had preexisting comorbidities.

CONCLUSIONS: The majority of BSI episodes managed in our hospital were either community-onset HCA or hospital-onset infections. This highlights the considerable importance of infection control and central venous catheter device care initiatives. Among community-associated BSI, S. aureus in association with osteoarticular infection was predominant.

Original languageEnglish
Pages (from-to)500-506
Number of pages7
JournalPediatric Infectious Disease Journal
Issue number6
Publication statusPublished - Jun 2020


  • Adolescent
  • Anti-Bacterial Agents/pharmacology
  • Australia/epidemiology
  • Bacteremia/epidemiology
  • Child
  • Child, Preschool
  • Colony Count, Microbial
  • Comorbidity
  • Cross Infection/epidemiology
  • Female
  • Gram-Negative Bacteria/drug effects
  • Gram-Positive Bacteria/drug effects
  • Hospitals, Pediatric/statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Medical Records
  • Retrospective Studies

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