Escherichia coli bacteremia in children. A review of 91 cases in 10 years.

We reviewed 91 cases of pediatric Escherichia coli bacteremia during a 10-year period. Thirty one patients were afebrile; a significantly greater proportion of these patients were aged less than 1 month, had ampicillin-resistant E coli isolates, or had persistent bacteremia 24 hours after initiating antibiotic therapy. Infection was community acquired in 65 cases; associated urinary tract infection was six times more common in this setting than in nosocomially acquired infections. In 85 cases at least 1 underlying medical condition/focus of infection was identified at the time the positive blood culture was obtained, the most common were immune deficiency states (38 cases), urinary tract infection (29 cases), and lesions of the gastrointestinal tract (27 cases). Polymicrobial bacteremia occurred in five cases. Twelve patients died; significantly associated with death were hypotension requiring pressor therapy, presence of a central venous catheter, and neutropenia.