Risk factors of bacteremia in children hospitalized with community-acquired pneumonia: A nested case-control study.

Abstract Objective To assess the risk factors of bacteremia in children hospitalized with community-acquired pneumonia (CAP). Study design The present, nested, case-control study enrolled a cohort of patients with CAP aged Results BCs were obtained for 2,383 (84%) of the 2,853 patients in the CAP cohort. Of those with BCs, 34 (1.4%) had bacteremia. S. pneumoniae and H. influenzae accounted for 26 (76%) and four (12%) instances of the bacteremia pathogens, respectively. Bacteremia occurred more frequently among patients hospitalized in the spring than during other seasons (P = 0.022). On multivariate analysis, the severity of pneumonia was not associated with bacteremia incidence (OR: 0.92 [0.30–2.85]) while a white blood cell count > 16,000/μL (OR: 5.90 [2.14–16.3]) was shown to be a significant risk factor. The OR of the need for a ventilator on admission day was significantly high (28.4 [3.02–1374]) on univariate analysis, but the subject pool was too small to determine its significance on multivariate analysis. Conclusions The results of the present study supported BC collection in patients with leukocytosis and in those requiring ventilator use on admission.