Pediatrics & Neonatology
Volume 50, Issue 1 , Pages 13-17, February 2009

Clinical Significance in Previously Healthy Children of Pseudomonas aeruginosa in the Stool

  • Ya-Lin Cheng

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Hung-Chang Lee

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • Department of Pediatrics, Taipei Medical University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Pediatrics, Mackay Memorial Hospital, 92 Section 2, Chung-Shan North Road, Taipei, Taiwan
    • ,
  • Chun-Yan Yeung

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Wai-Taow Chan

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan

Received 13 March 2007; received in revised form 8 August 2008; accepted 1 December 2008.

Article Outline

Background

Pseudomonas aeruginosa are normal flora in the human gastrointestinal (GI) tract, which on occasion cause GI tract infection.

Methods

We evaluated the clinical significance of a pure growth of P. aeruginosa in fecal specimens in previously healthy children. The records of 45 previously healthy children under 15 years of age who were seen between June 2000 and August 2006 and who had a pure growth of P. aeruginosa in the stool were retrospectively reviewed.

Results

Of the 45 children, 28 (62%) were infants, three of whom developed sepsis secondary to the pseudomonal infection; two of which died. Complications in another four included colonic perforation (in two), necrotizing enterocolitis (in one), and an anal ulcer resulting in anal stricture (in one). The seven children with complications were all infants. Although not all children in our study had complete data in laboratory determinations, the presence of bandemia, elevated C-reactive protein (CRP), anemia and hypoalbuminemia may be of clinical importance.

Conclusion

P. aeruginosa growing in the stool of otherwise healthy children may indicate actual infection by the organism and may be associated with severe or even fatal disease, particularly in infants. Bandemia, elevated CRP, anemia, and hypoalbuminemia give further warning in these patients.

Key Words:  children , feces , gastrointestinal , Pseudomonas aeruginosa

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Mutlu GM , Wunderink RG . Severe pseudomonal infections . Curr Opin Crit Care . 2006;12:458–463
  2. Porco FV , Visconte EB . Pseudomonas aeruginosa as a cause of infectious diarrhea successfully treated with oral ciprofloxacin . Ann Pharmacother . 1995;29:1122–1123
  3. Sekiguchi J , Asagi T , Miyoshi-Akiyama T , et al.   Outbreaks of multidrug-resistant Pseudomonas aeruginosa in community hospitals in Japan . J Clin Microbiol . 2007;45:979–989
  4. Duman M , Ozdemir D , Yi U , Korolu TF , Oren O , Berkta S . Multiple erythematous nodules and ecthyma gangrenosum as a manifestation of Pseudomonas aeruginosa sepsis in a previously healthy infant . Pediatr Dermatol . 2006;23:243–246
  5. Michail S , Sylvester F , Fuchs G , Issenman R . Clinical practice guideline: clinical efficacy of probiotics: review of the evidence, with focus on children . J Pediatr Gastroenterol Nutr . 2006;43:550–557
  6. Steinbruckner B , Fehrenbach J , Philippczik G , Kist M , Bauer TM . Clinical significance of pure or predominant growth of Pseudomonas aeruginosa in fecal specimens of medical patients . J Hosp Infect . 1999;43:164–165
  7. Yeung CK , Lee KH . Community acquired fulminant Pseudomonas infection of the gastrointestinal tract in previously healthy infants . J Paediatr Child Health . 1998;34:584–587
  8. Viola L , Langer A , Pulitano S , Chiaretti A , Piastra M , Polidori G . Serious Pseudomonas aeruginosa infection in healthy children: case report and review of the literature . Pediatr Int . 2006;48:330–333
  9. Yetkin G , Otlu B , Cicek A , Kuzucu C , Durmaz R . Clinical, microbiologic, and epidemiologic characteristics of Pseudomonas aeruginosa infections in an university hospital, Malatya, Turkey . Am J Infect Control . 2006;34:188–192
  10. Huang YC , Lin TY , Wang CH . Community-acquired Pseudomonas aeruginosa sepsis in previously healthy infants and children: analysis of forty-three episodes . Pediatr Infect Dis J . 2002;21:1049–1052
  11. Brent AJ , Oundo JO , Mwangi I , Ochola L , Lowe B , Berkley JA . Salmonella bacteremia in Kenyan children . Pediatr Infect Dis J . 2006;25:230–236
  12. Adlard PA , Kirov SM , Sanderson K , Cox GE . Pseudomonas aeruginosa as a cause of infectious diarrhea . Epidemiol Infect . 1998;121:237–241
  13. Huebner ES , Surawicz CM . Probiotics in the prevention and treatment of gastrointestinal infections . Gastroenterol Clin N Am . 2006;35:355–365
  14. Weng M , Walker WA . Bacterial colonization, probiotics, and clinical disease . J Pediatr . 2006;149(Suppl 5):S107–S114
  15. Bar-Meir M , Raveh D , Yinnon AM , Benenson S , Rudensky B , Schlesinger Y . Non-typhi Salmonella gastroenteritis in children presenting to the emergency department: characteristics of patients with associated bacteraemia . Clin Microbiol Infect . 2005;11:651–655

PII: S1875-9572(09)60024-3

doi:10.1016/S1875-9572(09)60024-3

Pediatrics & Neonatology
Volume 50, Issue 1 , Pages 13-17, February 2009

Article Tools