Bacterial Infections in Infants 60 Days and Younger

作者：Karin Berger Sadow, Robert Derr, Stephen J. Teach · 发表于：Archives of Pediatrics and Adolescent Medicine · 年份：1999 · DOI：10.1001/archpedi.153.6.611 · 被引用次数：39 · 研究领域：Neonatal and Maternal Infections、Bacterial Infections and Vaccines、Pediatric Urology and Nephrology Studies

OBJECTIVE: To establish what might be more optimal initial antibiotic therapy for suspected invasive bacterial infections in infants 60 days or younger who are evaluated in the emergency department (ED). SETTING: Urban university-affiliated pediatric referral center with an average yearly ED census of 52000 visits during the study period. DESIGN AND METHODS: We assembled a retrospective case series of all positive blood, urine, and cerebrospinal fluid cultures in children 60 days or younger from January 1, 1994, through December 31, 1997, obtained from both inpatients and patients initially evaluated in the ED. From this case series we determined the frequency of bacterial pathogens responsible for such infections in this age group. Pathogens were defined as group B streptococcus, various enteric gram-negative rods (GNRs), Listeria monocytogenes, enterococcus, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type B, and Staphylococcus aureus. A subgroup analysis was performed to determine resistance patterns among the GNRs isolated from patients evaluated in the ED. RESULTS: A total of 367 pathogens were isolated: 187 (51.0%) in the neonatal intensive care unit, 153 (41.7%) in the ED, 20 (5.4%) in the inpatient wards, and 7 (1.9%) in the pediatric intensive care unit. Of the 121 pathogens isolated from 120 ED patients that were eligible for review, 94 (77.7%) were in the urine only, 16 (13.2%) in blood only, 4 (3.3%) in cerebrospinal fluid only, 3 (2.5...