AIM: To evaluate the incidence of bacteremia, and the isolated pathogens, in well-appearing children with fever without source (FWS) presenting to the pediatric emergency department (PED), after pneumococcal conjucate vaccine - 7 valent (PCV-7) widespread introduction in the Veneto region of north-eastern Italy, and to review the main literature contributions on the subject. METHODS: Blood cultures performed at the PED of Padova from 1 June 2006 to 31 January 2009 in febrile children aged 1-36 months were retrospectively retrieved. Medical records of previously healthy well-appearing children with FWS were identified and reviewed. RESULTS: The study finally included 392 patients. Bacteremia rate was 0.34% (95% CI 0-1) in the age group 3-36 months and 2% (95% CI 0-4.7) in infants 1-3 months. No Streptococcus pneumoniae was isolated. The literature review identified 10 relevant studies carried out in the USA and Spain showing an overall bacteremia rate <1% for feverish children aged 3-36 months, with values <0.5% in settings with high PCV-7 coverage. CONCLUSION: Overall bacteremia rate is currently <0.5% in well-appearing children aged 3-36 months with FWS attending the PED in areas with PCV-7 widespread vaccination and is sufficiently low to preclude laboratory testing in favour of close follow-up. Further research is needed to evaluate a more conservative approach in infants 2-3 months of age.
AIM: To evaluate the incidence of bacteremia, and the isolated pathogens, in well-appearing children with fever without source (FWS) presenting to the pediatric emergency department (PED), after pneumococcal conjucate vaccine - 7 valent (PCV-7) widespread introduction in the Veneto region of north-eastern Italy, and to review the main literature contributions on the subject. METHODS: Blood cultures performed at the PED of Padova from 1 June 2006 to 31 January 2009 in febrile children aged 1-36 months were retrospectively retrieved. Medical records of previously healthy well-appearing children with FWS were identified and reviewed. RESULTS: The study finally included 392 patients. Bacteremia rate was 0.34% (95% CI 0-1) in the age group 3-36 months and 2% (95% CI 0-4.7) in infants 1-3 months. No Streptococcus pneumoniae was isolated. The literature review identified 10 relevant studies carried out in the USA and Spain showing an overall bacteremia rate <1% for feverish children aged 3-36 months, with values <0.5% in settings with high PCV-7 coverage. CONCLUSION: Overall bacteremia rate is currently <0.5% in well-appearing children aged 3-36 months with FWS attending the PED in areas with PCV-7 widespread vaccination and is sufficiently low to preclude laboratory testing in favour of close follow-up. Further research is needed to evaluate a more conservative approach in infants 2-3 months of age.
Authors: Prashant Mahajan; Nathan Kuppermann; Asuncion Mejias; Nicolas Suarez; Damien Chaussabel; T Charles Casper; Bennett Smith; Elizabeth R Alpern; Jennifer Anders; Shireen M Atabaki; Jonathan E Bennett; Stephen Blumberg; Bema Bonsu; Dominic Borgialli; Anne Brayer; Lorin Browne; Daniel M Cohen; Ellen F Crain; Andrea T Cruz; Peter S Dayan; Rajender Gattu; Richard Greenberg; John D Hoyle; David M Jaffe; Deborah A Levine; Kathleen Lillis; James G Linakis; Jared Muenzer; Lise E Nigrovic; Elizabeth C Powell; Alexander J Rogers; Genie Roosevelt; Richard M Ruddy; Mary Saunders; Michael G Tunik; Leah Tzimenatos; Melissa Vitale; J Michael Dean; Octavio Ramilo Journal: JAMA Date: 2016 Aug 23-30 Impact factor: 56.272
Authors: Liset Olarte; Krow Ampofo; Chris Stockmann; Edward O Mason; Judy A Daly; Andrew T Pavia; Carrie L Byington Journal: Pediatrics Date: 2013-06-03 Impact factor: 7.124
Authors: Ruud G Nijman; Yvonne Vergouwe; Matthew Thompson; Mirjam van Veen; Alfred H J van Meurs; Johan van der Lei; Ewout W Steyerberg; Henriette A Moll; Rianne Oostenbrink Journal: BMJ Date: 2013-04-02
Authors: Eugene Leibovitz; Nuphar David; Haya Ribitzky-Eisner; Mouner Abo Madegam; Said Abuabed; Gabriel Chodick; Michal Maimon; Yariv Fruchtman Journal: Int J Environ Res Public Health Date: 2016-07-19 Impact factor: 3.390