Hostname: page-component-745bb68f8f-g4j75 Total loading time: 0 Render date: 2025-02-02T04:34:40.848Z Has data issue: false hasContentIssue false
  • English
  • Français

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])
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Herold, BC, Immergluck, LC, Maranan, MC, et al.Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998;279:593–598.CrossRefGoogle ScholarPubMed
2.Kaplan, SL, Hulten, KG, Gonzalez, BE, et al.Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clin Infect Dis 2005;40:1785–1791.CrossRefGoogle ScholarPubMed
3.Purcell, K, Fergie, J. Epidemic of community-acquired methicillin-resistant Staphylococcus aureus infections: a 14-year study at Driscoll Children's Hospital. Arch Pediatr Adolesc Med 2005;159:980–985.Google Scholar
4.Seal, JB, Moreira, B, Bethel, CD, Daum, RS. Antimicrobial resistance in Staphylococcus aureus at the University of Chicago Hospitals: a 15-year longitudinal assessment in a large university-based hospital. Infect Control Hosp Epidemiol 2003;24:403–408.Google Scholar
5.Ochoa, TJ, Mohr, J, Wanger, A, Murphy, JR, Heresi, GPCommunity-associated methicillin-resistant Staphylococcus aureus in pediatric patients. Emerg Infect Dis 2005;11:966–968.Google Scholar
6.Buckingham, SC, McDougal, LK, Cathey, LD, et al.Emergence of community-associated methicillin-resistant Staphylococcus aureus at a Memphis, Tennessee Children's Hospital. Pediatr Infect Dis J 2004;23:619–624.CrossRefGoogle Scholar
7.Chen, AE, Goldstein, M, Carroll, K, Song, X, Perl, TM, Sibeny, GK. Evolving epidemiology of pediatric Staphylococcus aureus cutaneous infections in a Baltimore hospital. Pediatr Emerg Care 2006;22:717–723.Google Scholar
8.Fortunov, RM, Hulten, KG, Hammerman, WA, Mason, EO Jr, Kaplan, SL. Community-acquired Staphylococcus aureus infections in term and near-term previously healthy neonates. Pediatrics 2006;118:874–881.Google Scholar
9.Mishaan, AM, Mason, EO Jr, Martinez-Aguilar, G, et al.Emergence of a predominant clone of community-acquired Staphylococcus aureus among children in Houston, Texas. Pediatr Infect Dis J 2005;24:201–206.Google Scholar
10.Jungk, J, Como-Sabetti, K, Stinchfield, P, Ackerman, P, Harriman, K. Epidemiology of methicillin-resistant Staphylococcus aureus at a pediatric healthcare system, 1991–2003. Pediatr Infect Dis J 2007;26:339–344.CrossRefGoogle Scholar
11.Elston, DM. Community-acquired methicillin-resistant Staphylococcus aureus. J Am Acad Dermatol 2007;56:1–16.Google Scholar
12.Olesevich, M, Kennedy, A. Emergence of community-acquired methicillin-resistant Staphylococcus aureus soft tissue infections. J Pediatr Surg 2007;42:765–768.Google Scholar
13.Zaoutis, TE, Toltzis, P, Chu, J, et al.Clinical and molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus infections among children with risk factors for health care-associated infection: 2001–2003. Pediatr Infect Dis J 2006;25:343–348.Google Scholar
14.Hakim, H, Mylotte, JM, Faden, H. Morbidity and mortality of staphylococcal bacteremia in children. Am J Infect Control 2007;35:102–105.Google Scholar
15.Gonzalez, BE, Martinez-Aguilar, G, Hulten, KG, et al.Severe staphylococcal sepsis in adolescents in the era of community-acquired methicillin-resistant Staphylococcus aureus. Pediatrics 2005;115:642–648.Google Scholar
16.Friedland, IR, du Plessis, J, Cilliers, A. Cardiac complications in children with Staphylococcus aureus bacteremia. J Pediatr 1995;127:746–748.Google Scholar
17.Herz, AM, Greenhow, TL, Alcantara, J, et al.Changing epidemiology of outpatient bacteremia in 3- to 36-month-old children after the introduction of the heptavalent-conjugated pneumococcal vaccine. Pediatr Infect Dis J 2006;25:293–300.Google Scholar
18.Healy, CM, Palazzi, DL, Edwards, MS, Campbell, JR, Baker, CJ. Features of invasive staphylococcal disease in neonates. Pediatrics 2004;114:953–961.CrossRefGoogle ScholarPubMed
19.Gorenstein, A, Gross, E, Houri, S, Gewirts, G, Katz, S. The pivotal role of deep vein thrombophlebitis in the development of acute disseminated staphylococcal disease in children. Pediatrics 2000;106:E87.Google Scholar
20.Hevens, RM, Morrison, MA, Petit, S, et al.Invasive methicillin-resistant Staphylococcus infections in the United States. JAMA 2007;298:1763–1771.Google Scholar
21.Frederiksen, MS, Espersen, F, Frimodt-Moller, N, et al.Changing epidemiology of pediatric Staphylococcus aureus bacteremia in Denmark from 1971 through 2000. Pediatr Infect Dis J 2007;26:398–405.CrossRefGoogle ScholarPubMed
22.Steinberg, JP, Clark, CC, Hackman, BO. Nosocomial and community-acquired Staphylococcus aureus bacteremias from 1980 to 1993: impact of intravascular devices and methicillin resistance. Clin Infect Dis 1996;23:255–259.CrossRefGoogle ScholarPubMed
23.Miles, F, Voss, L, Segedin, E, Anderson, BJ. Review of Staphylococcus aureus infections requiring admission to a paediatric intensive care unit. Arch Dis Child 2005;90:1274–1278.Google Scholar
24.Suryati, BA, Watson, M. Staphylococcus aureus bacteraemia in children: a 5-year retrospective review. J Paediatr Child Health 2002;38:290–294.CrossRefGoogle ScholarPubMed
25.Valente, AM, Jain, R, Scheurer, M, et al.Frequency of infective endocarditis among infants and children with Staphylococcus aureus bacteremia. Pediatrics 2005;115:e15–e19.Google Scholar
26.Das, I, O'Connell, N, Lambert, P. Epidemiology, clinical and laboratory characteristics of Staphylococcus aureus bacteraemia in a university hospital in UK. J Hosp Infect 2007;65:117–123.Google Scholar
27.Bader, MS. Staphylococcus aureus bacteremia in older adults: predictors of 7-day mortality and infection with a methicillin-resistant strain. Infect Control Hosp Epidemiol 2006;27:1219–1225.CrossRefGoogle ScholarPubMed
28.Denniston, S, Riordan, FA. Staphylococcus aureus bacteraemia in children and neonates: a 10 year retrospective review. J Infect 2006;53:387–393.Google Scholar
29.Hill, PC, Wong, CG, Voss, LM, et al.Prospective study of 125 cases of Staphylococcus aureus bacteremia in children in New Zealand. Pediatr Infect Dis J 2001;20:868–873.Google Scholar
30.Gray, JW. A 7-year study of bloodstream infections in an English children's hospital. Eur J Pediatr 2004;163:530–535.Google Scholar
31.Adedeji, A, Gray, JW. MRSA at an English children's hospital from 1998 to 2003. Arch Dis Child 2005;90:720–723.Google Scholar
32.Seybold, U, Kourbatova, EV, Johnson, JG, et al.Emergence of community-associated methicillin-resistant Staphylococcus aureus USA300 genotype as a major cause of health care-associated blood stream infections. Clin Infect Dis 2006;42:647–656.CrossRefGoogle Scholar
33.Chuang, YY, Huang, YC, Lee, CY, Lin, TY, Lien, R, Chou, YH. Methicillin-resistant Staphylococcus aureus bacteraemia in neonatal intensive care units: an analysis of 90 episodes. Acta Paediatr 2004;93:786–790.Google Scholar
34.Khairulddin, N, Bishop, L, Lamagni, TL, Sharland, M, Duckworth, G. Emergence of methicillin resistant Staphylococcus aureus (MRSA) bacteraemia among children in England and Wales, 1990–2001. Arch Dis Child 2004;89:378–379.CrossRefGoogle ScholarPubMed
35.Maree, CL, Daum, RS, Boyle-Vavra, S, Matayoshi, K, Miller, LG. Community-associated methicillin-resistant Staphylococcus aureus isolates causing healthcare-associated infections. Emerg Infect Dis 2007;13:236–242.Google Scholar
36.Tacconelli, E, Venkataraman, L, De Girolami, PC, D'Agata, EM. Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains. J Antimicrob Chemother 2004;53:474–479.Google Scholar
37.Sattler, CA, Mason, EO Jr, Kaplan, SL. Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children. Pediatr Infect Dis J 2002;21:910–917.CrossRefGoogle ScholarPubMed