What are the pathogenic agents isolated from blood cultures in children?
The very large majority of organisms that cause IE in children are Gram-positive cocci (Table 5), including VGS (eg, Streptococcus sanguis, S mitis group, S mutans), staphylococci (both S aureus and coagulase-negative staphylococci), -hemolytic streptococci, and enterococci.11,13,24,81 Enterococcal endocarditis is relatively less common in children than in adults. Less frequently, other organisms such as the HACEK group of organisms (HACEK indicates Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are implicated. After the first year of life, VGS are generally the most frequently isolated organisms in patients with IE caused by underlying congenital heart disease.