Comparing the incidence of bacteremia in children, ranging from three months of age to three years, before and after the vaccination against Streptococcus pneumoniae, at Padeh Poriya Hospital.
2רפואה, אוניברסיטת בר אילן, ישראל
Abstract: Before the era of vaccination against the bacterium Streptococcus pneumoniae, it was one of the most common contaminants in children, and isolated from many blood cultures. Since the introduction of the vaccine, there has been a change in the distribution of pathogens among children in general, and the incidence rate of Streptococcus pneumoniae has decreased.
Goals: Comparing the incidence of latent bacteremia in children, ranging from three months of age to three years, between 2006-2009 (before the vaccination era) compared to 2014-2017 (after the vaccination was introduced), at Padeh Poriya Hospital.
Methods: The study is retrospective, in which all blood cultures taken to children between the ages of three months and three years in 2006-2009 will be reviewed, as well as in 2014-2017, addressing the types and sensitivities of the different bacteria, as well as the clinical and laboratory data.
Results: The total number of cases which included a positive blood culture before the vaccine era was 40 (1%), compared to 29 (0.7%) after the vaccine was introduced. In 14% of children with bacteremia, three criteria were found: Leukocytosis over 15000 cells per microliter, neutrophilia over 70%, and fever ≥ C°39. In addition, Streptococcus pneumoniae susceptibility to 6 antibiotics was tested, during the pre- and post-vaccination period, and for the first generation of Cephalosporins – Cefazolin, resistance increased from zero to 27%, before and after vaccination, accordingly.
Conclusion: Detecting and monitoring the bacterial growth of Streptococcus pneumoniae in blood cultures of children, in addition to characterizing the various strains of the same bacterium, can provide information concerning the ability of the vaccine to significantly lower infections, and emphasize the importance of taking routine blood cultures for children vaccinated against Streptococcus pneumoniae who visit the emergency room with high fever.