Bacteremic Pneumonia increases ICU admissions, hospital stays in children

The presence of community-acquired pneumonia and bacteremia results in longer hospital stays, intensive care unit (ICU) admissions, and invasive mechanical ventilation or shock, among children, according to a recent study published in the journal Pediatrics.

The study found that among 2,143 US children with community-acquired pneumonia, 2.2% had bacteremia, with resulting longer hospital stays and intensive care unit(ICU) admissions.

Previous studies examining bacteremia in hospitalized children with pneumonia are limited by incomplete culture data. Cristin Q. Fritz, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee, and colleagues sought to determine characteristics of children with bacteremic pneumonia using data from a large prospective study with systematic blood culturing.

For the purpose, they used blood cultures to determine prevalence among patients below the age of 18 years who were hospitalized with pneumonia between 2010 and 2012.

Associations between bacteremia and clinical outcomes were assessed by using Cox proportional hazards regression for a length of stay and logistic regression for ICU admission and invasive mechanical ventilation or shock.

Also Read: Corticosteroids use in influenza pneumonia linked to increased mortality, ICU stay

Key findings of the study include:

• Blood cultures were obtained in 2143 (91%) of 2358 children; 46 (2.2%) had bacteremia.


• The most common pathogens were Streptococcus pneumoniae (n = 23, 50%), Staphylococcus aureus (n = 6, 13%), and Streptococcus pyogenes (n = 4, 9%).


• Characteristics associated with bacteremia included male sex, parapneumonic effusion, lack of chest indrawing or wheezing, and no previous receipt of antibiotics.


• Children with bacteremia had longer lengths of stay (median: 5.8 vs 2.8 days) and increased odds of intensive care unit(ICU) admission (43% vs 21%) and invasive mechanical ventilation or shock (30% vs 8%).

Also Read: Study supports shorter antibiotics treatment for bacteremia

"Bacteremia was uncommonly detected in this large multicenter cohort of children hospitalized with community-acquired pneumonia but was associated with severe disease. S pneumoniae was detected most often," concluded the authors.

The authors suggest the low rate of bacteremia could be explained by the wide use of antibiotics before culture, and viral causes of pneumonia.

To access the complete study log on to doi: 10.1542/peds.2018-3090