[Occult bacteremia in Sótero del Río Hospital: Experience after pneumococcal conjugated vaccine]

Abstract

Background: Occult bacteremia (OB) is one of the possible diagnoses of children younger than 3 years with fever without source in the emergency room.

Objective: describe OB in the era after introduction of pneumococcal vaccine in Chile.

Patients and methods: Prospective descriptive review of data of children with possible OB diagnosis, referred from the emergency department between 2010-2013.

Results: Possible OB was diagnosed on 391 patients. 233 had focus, mainly respiratory virus and urinary tract infection. On 158 patients, probable BO was diagnosed, 20 had proven OB from which 15 had positive blood culture for Streptococcus pneumoniae. From these, 7 were fully or partially vaccinated. The serotype was identified on 14 cases: 6 were PCV10 vaccine serotypes (none of them vaccinated), 2 were serotype related (both partially vaccinated) and 6 were non vaccine serotypes (partially or totally vaccinated).

Discussion: It is necessary to improve diagnostic methods for respiratory viruses and urinary tract infections and try to expand coverage of pneumococcal conjugated vaccines in the pediatric population in order to reduce the risk of invasive pneumococcal disease in Chile.