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Pediatric and Neonatal Staphylococcus aureus Bacteremia Epidemiology, Risk Factors, and Outcome

Published online by Cambridge University Press:  02 January 2015

Robert E. Burke ,
Meira S. Halpern ,
Ellen Jo Baron  and
Kathleen Gutierrez
Robert E. Burke
Affiliation:
Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
Meira S. Halpern*
Affiliation:
Division of Pediatric Infectious Diseases, School of Medicine, Stanford University, Stanford, Clinical Microbiology Laboratory, Stanford University Medical Center, Palo Alto, California
Kathleen Gutierrez
Affiliation:
Division of Pediatric Infectious Diseases, School of Medicine, Stanford University, Stanford, Clinical Microbiology Laboratory, Stanford University Medical Center, Palo Alto, California
*
Division of Pediatric Infectious Diseases, School of Medicine, Stanford University, Stanford, CA 94305 ([email protected])
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Abstract

Objective.

To evaluate the impact of methicillin-resistant Staphylococcus aureus on the prevalence of S. aureus bloodstream infection among children.

Methods.

Retrospective analysis of demographic data, risk factors for infection, and clinical outcomes for children (age, less than 18 years) with S. aureus bacteremia hospitalized at a children's hospital during 2001–2006.

Results.

We identified 164 episodes of S. aureus bacteremia among 151 children. The prevalence of bacteremia due to methicillin-susceptible S. aureus during 2001–2003 was approximately the same as that during 2004–2006 (29 and 30 cases, respectively, per 10,000 hospitalized children [hereafter, “per 10,000 hospitalizations”]), but the prevalence of bacteremia due to methicillin-resistant S. aureus increased from 4 to 11 cases, respectively, per 10,000 hospitalizations (P = .015). A total of 48% of infections involved children who had S. aureus-positive blood cultures less than 3 days after hospital admission. Seventy-four percent of these children had a preexisting comorbidity. When the prevalence of S. aureus bacteremia was stratified by race, sex, or age, neonates hospitalized at birth and Hispanic children had significantly reduced risks of infection. Children younger than 1 year of age (excluding neonates hospitalized at birth) had an increased prevalence of hospital-onset S. aureus bacteremia. There was a disproportionate increase in the risk of S. aureus bacteremia for each additional week of hospitalization among children with hospital-onset S. aureus bacteremia. Children with methicillin-resistant S. aureus bacteremia had a longer hospital stay, were transferred to another facility at a greater rate than they were discharged home, and had a greater mortality rate, compared with children with methicillin-susceptible S. aureus bacteremia.

Conclusion.

This study documents the prevalence of S. aureus bacteremia among children with a high risk for acquiring this infection, and it describes populations of children who are at higher risk for bacteremia due to either methicillin-susceptible or methicillin-resistant S. aureus. Methods to improve prevention of S. aureus bacteremia are needed for children with healthcare-associated risk factors for S. aureus bacteremia.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 7 , July 2009 , pp. 636 - 644
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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