• Ann Emerg Med · Jun 2007

    Comparative Study

    Pneumococcal bacteremia in febrile infants presenting to the emergency department before and after the introduction of the heptavalent pneumococcal vaccine.

    • Keri L Carstairs, David A Tanen, Andrew S Johnson, Steven B Kailes, and Robert H Riffenburgh.
    • Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, CA 92134-5000, USA. kerilynmd@yahoo.com <kerilynmd@yahoo.com>
    • Ann Emerg Med. 2007 Jun 1; 49 (6): 772-7.

    Study ObjectiveFever is among the most common presenting complaints of infants and children younger than 3 years who present to the emergency department (ED). The evaluation and management of the febrile child is evolving rapidly. We compare the proportion of pneumococcal bacteremia between febrile infants and children younger than 3 years who had and had not received the heptavalent pneumococcal vaccine and who had received blood culture tests in our ED.MethodsWe performed a non-concurrent prospective observational cohort study, with a standardized medical record review to collect data of patients treated in the ED of a tertiary care military hospital during 24 months. Patients were eligible if they were younger than 36 months and had a temperature greater than or equal to 100.4 degrees F (38 degrees C). A data collection sheet was used to abstract age, temperature, and whether CBC count and blood cultures were obtained. Heptavalent pneumococcal vaccine status and blood culture results were obtained through review of the computerized medical record. Descriptive analysis was used for comparing the 2 groups. Group size analysis was based on the prevalence of occult bacteremia caused by Pneumococcus before the introduction of heptavalent pneumococcal vaccine. Interobserver variation was assessed by independent review of 10% of abstracted records. The main outcome measure was the proportion of positive pneumococcal blood cultures in infants and children younger than 3 years who had received at least 1 vaccination of heptavalent pneumococcal vaccine versus those who had not.ResultsThree thousand five hundred seventy-one patients met entry criteria; 1,428 had blood cultures obtained, and 833 of them received at least 1 immunization of heptavalent pneumococcal vaccine. All groups were similar in age, sex, and temperature. Positive blood culture results, including probable contaminants, were obtained for 4.2% (58/1,383) of the patients. In the heptavalent pneumococcal vaccine group, there were 0 of 833 (0%) positive pneumococcal blood cultures compared with 13 of 550 (2.4%) in the unimmunized group (P<.001; 95% confidence interval 1.4% to 3.3%).ConclusionPneumococcal bacteremia was found to be lower in our patients who had received the heptavalent pneumococcal vaccine than in the patients who had not.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.