Invasive Escherichia coli infections in infancy
Tsai C-H1, Huang Y-S1, Liu C-C1,
Wang S-M2, Yang Y-J1
Departments of 1Pediatrics and 2Emergency Medicine, National Cheng Kung
University Hospital, Tainan, Taiwan
Object: To study the clinical
features and outcome of invasive Escherichia coli infections in infancy.
Methods: A retrospective
review of medical records of all children with invasive E.coli infections
was done at National Cheng Kung University Hospital. They were stratified
into three groups according to age of disease onset: (a) at birth to 7 days
old, (b) 7 days to 1 month old, and (c) beyond 1 month old.
Results: During a 12-year
period from January 1988 to December 2000, 46 infants (M:F = 3.6:1) with E.
coli sepsis or central nerve system (CNS) infections were diagnosed at our
hospital. Among them, 13 had sepsis, 24 with urosepsis and 9 with
meningitis or meningoencephalitis. All patients with CNS infections were
younger than 40 days old. In the urosepsis group, 91.7% (22/24) were younger
than 6 months old with male predominant (20:4) and 29.2% (7/24) had urinary
tract anomaly. 68.0% (9/13) cases with sepsis had underlying diseases. The
most common clinical presentations in invasive E. coli infection were fever (89.1%), followed by tachycardia (71.7%), ill looking (50.0%).
(1988~1993 vs. 1994~2000).
Conclusion: Our study showed that invasive E. coli infections in infancy were
male predominant in urosepsis group. The disease entity is age related and
associated with the underlying conditions. The clinical symptoms and signs,
and laboratory results are mainly related to the age.