Aim
Escherichia coli (E coli) is a known cause of paediatric bacteraemia. The main objective was to characterise the emergency department (ED) presentations of paediatric E coli bacteraemia and secondarily to identify those related to greater severity.
Methods
This was a sub‐study of a multicentre cross‐sectional prospective registry including all with E coli bacteraemia episodes between 2011 and 2016. We used multiple correspondence and cluster analysis to identify different patterns.
Results
We included 291 patients and 43 met criteria for severe disease (14.3%, 95% confidence interval 11.2‐19.3). We identified four types of paediatric E coli bacteraemia presentations. Two (178 patients, 61.2%) were related to well‐appearing previously healthy infants with associated urinary tract infection (UTI). Well‐appearing children older than 12 months old with underlying disease (n = 60, 20.6%) and non‐well‐appearing children of different ages (n = 53, 18.2%) corresponded to the other two types; these had associated UTI infrequently and higher severity rate (15% and 50.9%, respectively, higher when compared with the two previous types, P < .01), including the two patients who died.
Conclusion
There were four different types of ED paediatric E coli bacteraemia presentations with different severity. Febrile young children with associated UTI showed the best outcome.
We carried out a prospective multicenter study including 203 previously healthy well-appearing children who were 3–24 months old with fever without a source ≥40.5°C. Thirty-one (15.3%, 95% confidence interval 11.0–20.9) were diagnosed with serious bacterial infection, including 6 with bacteremia (3%, 95% confidence interval 1.4–6.3). Testing for occult bacteremia in children 3–24 months old with fever without a source should be considered when fever at ≥40.5°C.
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