Septicemia in a university pediatric hospital: a five-year analysis of the bacterial and fungal isolates and outcome of the infections.

A 5-year analysis comprising all positive blood culture isolates from a 222-bed university pediatric hospital in Helsinki revealed 369 bacteremic but only 8 fungemic cases. Haemophilus influenzae and Staphylococcus aureus, 19% of the total material each, were the most common pathogens isolated, followed by S. epidermidis (11%), Escherichia coli (8%), pneumococci (8%), and group B beta-hemolytic streptococci (6%). Remarkable differences in distribution of the pathogens were observed in different hospital units. However, 5 most common microorganisms covered 62-86% of the spectrum in each unit. Two bacteria, H. influenzae in the unit for infectious diseases and S. aureus in the hematology-oncology unit were significantly (p less than 0.001 or less than 0.01, respectively) more common than any other organism in those units. The average case fatality rate was 14% with a range from 1.5% to 40%, depending upon the causative agent isolated. Also, the mortality was much higher in neonates than in other age groups. We conclude that by monitoring the blood isolates separately in each unit one can find remarkable differences in the same hospital. On the other hand, characteristics of an individual hospital may vary significantly from those described in textbooks. These characteristics should be recognized and taken into account in the antimicrobial policy.