Risk factors of bacteremia in children hospitalized with community-acquired pneumonia: A nested case-control study

Autor: Yoshihiko Morikawa, Hiroshi Hataya, Tetsuji Kaneko, Shogo Akahoshi, Asami Sekine, Toshimasa Obonai, Hiroshi Sakakibara
Rok vydání: 2020
Předmět:
Zdroj: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 27(8)
ISSN: 1437-7780
Popis: To assess the risk factors of bacteremia in children hospitalized with community-acquired pneumonia (CAP).The present, nested, case-control study enrolled a cohort of patients with CAP aged18 years who were hospitalized at Tokyo Metropolitan Children's Medical Center or Tama-Hokubu Medical Center between March 2010 and February 2018. Among the cohort with blood cultures (BCs), patients with bacteremia were identified and matched with five control patients based on their treatment facility, underlying disease, and age. Conditional logistic regression was used to calculate the odds ratios (ORs) of bacteremia for risk factor candidates.BCs were obtained for 2,383 (84%) of the 2,853 patients in the CAP cohort. Of those with BCs, 34 (1.4%) had bacteremia. S. pneumoniae and H. influenzae accounted for 26 (76%) and four (12%) instances of the bacteremia pathogens, respectively. Bacteremia occurred more frequently among patients hospitalized in the spring than during other seasons (P = 0.022). On multivariate analysis, the severity of pneumonia was not associated with bacteremia incidence (OR: 0.92 [0.30-2.85]) while a white blood cell count 16,000/μL (OR: 5.90 [2.14-16.3]) was shown to be a significant risk factor. The OR of the need for a ventilator on admission day was significantly high (28.4 [3.02-1374]) on univariate analysis, but the subject pool was too small to determine its significance on multivariate analysis.The results of the present study supported BC collection in patients with leukocytosis and in those requiring ventilator use on admission.
Databáze: OpenAIRE
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