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Enterococcal Bacteremia in a Pediatric Institution: A Four-Year Review Jean M. Boulanger, E. Lee Ford-Jones, and Anne G. Matlow
From the Departments of Microbiology and Paediatrics, Hospital for Sick Children; and the Departments of Paediatrics, Medicine, and Microbiology, University of Toronto, Toronto, Ontario, Canada
The clinical significance of enterococcal bacteremia in children has not been well defined, nor has appropriate treatment been delineated. Previously reported series of pediatric cases of enterococcal bacteremia have been small and restricted to the neonatal population [1, 2]. We report the results of a retrospective review of 50 cases of enterococcal bacteremia occurring in patients at the Hospital for Sick Children in Toronto from 1985 through 1989. Our purpose is to describe the clinical, epidemiologic, and microbiologic features of enterococcal bacteremia in a pediatric population.
1989 were identified through health records and computerized microbiology records. Of 76 children from whose antemortem blood culture(s) 77 isolates of Enterococcus were obtained, 50 were included in a complete review because both medical records and stocked isolates were available. The following clinical information was determined by chart review: demographic data, medical conditions present, systemic antimicrobial therapy administered, surgical procedures performed, and outcome during hospitalization.
Definitions
Methods Population and Case Finding
The Hospital for Sick Children is a 550-bed tertiary care pediatric hospital that includes a 45-bed neonatal intensive care unit. The population of patients includes the following groups: neonates «28 days old), 5 %; infants and toddlers (28 days to 2 years old), 25 %; preschoolers (2-4 years old), 21%; children 5-12 years old, 30%; teenagers 12-15 years old, 11%; and adolescents ~16 years old, 8 %. Patients who had enterococcal bacteremia at some point during the interval from September 1985 through November
Received 10 July 1990; revised 2 November 1990. Reprints and correspondence: Dr. Anne Matlow, Department of Microbiology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. Financial support: Lederle Laboratories Division, Cyanamid Canada Inc. Reviews of Infectious Diseases 1991;13:847-56 © 1991 by The University of Chicago. All rights reserved. 0162-0886/9111305-0031$02.00
Neonates were defined as infants who were 28 days who had been in the hospital since birth. All other patients
Enterococcal Bacteremia in a Pediatric Institution: A Four-Year Review Jean M. Boulanger, E. Lee Ford-Jones, and Anne G. Matlow
From the Departments of Microbiology and Paediatrics, Hospital for Sick Children; and the Departments of Paediatrics, Medicine, and Microbiology, University of Toronto, Toronto, Ontario, Canada
The clinical significance of enterococcal bacteremia in children has not been well defined, nor has appropriate treatment been delineated. Previously reported series of pediatric cases of enterococcal bacteremia have been small and restricted to the neonatal population [1, 2]. We report the results of a retrospective review of 50 cases of enterococcal bacteremia occurring in patients at the Hospital for Sick Children in Toronto from 1985 through 1989. Our purpose is to describe the clinical, epidemiologic, and microbiologic features of enterococcal bacteremia in a pediatric population.
1989 were identified through health records and computerized microbiology records. Of 76 children from whose antemortem blood culture(s) 77 isolates of Enterococcus were obtained, 50 were included in a complete review because both medical records and stocked isolates were available. The following clinical information was determined by chart review: demographic data, medical conditions present, systemic antimicrobial therapy administered, surgical procedures performed, and outcome during hospitalization.
Definitions
Methods Population and Case Finding
The Hospital for Sick Children is a 550-bed tertiary care pediatric hospital that includes a 45-bed neonatal intensive care unit. The population of patients includes the following groups: neonates «28 days old), 5 %; infants and toddlers (28 days to 2 years old), 25 %; preschoolers (2-4 years old), 21%; children 5-12 years old, 30%; teenagers 12-15 years old, 11%; and adolescents ~16 years old, 8 %. Patients who had enterococcal bacteremia at some point during the interval from September 1985 through November
Received 10 July 1990; revised 2 November 1990. Reprints and correspondence: Dr. Anne Matlow, Department of Microbiology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. Financial support: Lederle Laboratories Division, Cyanamid Canada Inc. Reviews of Infectious Diseases 1991;13:847-56 © 1991 by The University of Chicago. All rights reserved. 0162-0886/9111305-0031$02.00
Neonates were defined as infants who were 28 days who had been in the hospital since birth. All other patients
