- Vaccination status does not appear to be significantly associated with bacteremia in very young children presenting to the pediatric emergency department (ED).
- Haemophilus influenzae type B (Hib) and Streptococcus pneumoniae were specifically assessed in this study.
Why this matters
- Maternal antibodies appear to protect children ages 2-6 months against S pneumoniae and Hib.
- Authors: bacteremia, particularly with these pathogens, is uncommon in this age group, and blood culture contamination occurs often.
- 4742 encounters included.
- Incidence of bacteremia was 1.5%.
- Incidence of contaminated cultures was 5.0%.
- 15.16% children were unvaccinated, and 6.64% were undervaccinated for age.
- Relative risk for bacteremia vs fully vaccinated-for-age children:
- Unvaccinated: 0.79 (95% CI, 0.39-1.59).
- Undervaccinated: 1.20 (95% CI, 0.52-2.75).
- 6 children had vaccine-preventable bacteremia (5 with S pneumoniae, 1 with Hib).
- Bacteremia was associated (aORs) with:
- Older age: 1.05 (P=.041).
- Increased white blood count: 1.09 (P<.001>
- Increased absolute band count: 1.05 (P=.008).
- Ill-appearance: 6.01 (P<.001>
- No S pneumoniae or Hib was found in undervaccinated children, ages 2-6 months, but the higher culture contamination rates (6.6%) were higher vs children ages 7-36 months (average 3.7%).
- Retrospective cohort study evaluating association between bacteremia and vaccination status (Hib, S pneumoniae) in children ages 2-36 months presenting to a US pediatric ED.
- Funding: None disclosed.
- Retrospective, single center.
- Missing data.
- Limited generalizability.