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Paediatric Staphylococcus aureus bacteraemia: A single-centre retrospective cohort.
J Paediatr Child Health 2017; 53(2):180-186JP

Abstract

AIM

We aimed to describe the clinical epidemiology of Staphylococcus aureus bacteraemia (SAB) at a large, tertiary/quaternary children's hospital in Australia.

METHODS

We performed a retrospective chart review of SAB cases at the Children's Hospital at Westmead (CHW) over 5 years; 2006-2011. We compared frequency, clinical profile and outcomes of SAB with published data from CHW; 1994-1998. We compared health-care associated with community-associated (HCA-SAB and CA-SAB; defined epidemiologically) and methicillin-resistant with methicillin susceptible S. aureus (MRSA and MSSA).

RESULTS

We identified 174 episodes of paediatric SAB with an average annual admission rate of 1.3/1000 which has not increased compared with a decade earlier. Half of the cases (49%) were CA-SAB; 18% were MRSA. The proportion of CA-MRSA bacteraemia (22%) has increased. The proportion of SAB associated with central venous access devices (CVADs; 40%) has increased. CA-SAB cases were more likely to present with a tissue focus of disease (e.g. osteo-articular, pneumonia) and often required surgery. HCA-SAB less frequently required surgery, a minority is MRSA, and vascular device intervention (removal, sterilisation) is common. Six cases (4%) of infective endocarditis (IE) were identified; three with a history of congenital heart disease, two with CVADs in situ. There were no deaths in this cohort.

CONCLUSIONS

Over an 18-year period, the proportion of SAB due to CA-MRSA and SAB associated with CVADs has increased. Categorisation of SAB as HCA and CA reveals two broad phenotypes of paediatric SAB. SAB in children is infrequently associated with IE. The health-care burden of paediatric SAB is considerable', but mortality is low.

Authors+Show Affiliations

Department of General Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.Clinical Epidemiology Unit, Canberra Hospital, Canberra, Australian Capital Territory, Australia.Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27566273

Citation

Roediger, Jessica C., et al. "Paediatric Staphylococcus Aureus Bacteraemia: a Single-centre Retrospective Cohort." Journal of Paediatrics and Child Health, vol. 53, no. 2, 2017, pp. 180-186.
Roediger JC, Outhred AC, Shadbolt B, et al. Paediatric Staphylococcus aureus bacteraemia: A single-centre retrospective cohort. J Paediatr Child Health. 2017;53(2):180-186.
Roediger, J. C., Outhred, A. C., Shadbolt, B., & Britton, P. N. (2017). Paediatric Staphylococcus aureus bacteraemia: A single-centre retrospective cohort. Journal of Paediatrics and Child Health, 53(2), pp. 180-186. doi:10.1111/jpc.13329.
Roediger JC, et al. Paediatric Staphylococcus Aureus Bacteraemia: a Single-centre Retrospective Cohort. J Paediatr Child Health. 2017;53(2):180-186. PubMed PMID: 27566273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paediatric Staphylococcus aureus bacteraemia: A single-centre retrospective cohort. AU - Roediger,Jessica C, AU - Outhred,Alexander C, AU - Shadbolt,Bruce, AU - Britton,Philip N, Y1 - 2016/08/27/ PY - 2015/12/08/received PY - 2016/05/06/revised PY - 2016/06/19/accepted PY - 2016/8/28/pubmed PY - 2017/10/19/medline PY - 2016/8/28/entrez KW - Staphylococcus aureus KW - bacteraemia KW - endocarditis KW - general paediatrics KW - infectious diseases SP - 180 EP - 186 JF - Journal of paediatrics and child health JO - J Paediatr Child Health VL - 53 IS - 2 N2 - AIM: We aimed to describe the clinical epidemiology of Staphylococcus aureus bacteraemia (SAB) at a large, tertiary/quaternary children's hospital in Australia. METHODS: We performed a retrospective chart review of SAB cases at the Children's Hospital at Westmead (CHW) over 5 years; 2006-2011. We compared frequency, clinical profile and outcomes of SAB with published data from CHW; 1994-1998. We compared health-care associated with community-associated (HCA-SAB and CA-SAB; defined epidemiologically) and methicillin-resistant with methicillin susceptible S. aureus (MRSA and MSSA). RESULTS: We identified 174 episodes of paediatric SAB with an average annual admission rate of 1.3/1000 which has not increased compared with a decade earlier. Half of the cases (49%) were CA-SAB; 18% were MRSA. The proportion of CA-MRSA bacteraemia (22%) has increased. The proportion of SAB associated with central venous access devices (CVADs; 40%) has increased. CA-SAB cases were more likely to present with a tissue focus of disease (e.g. osteo-articular, pneumonia) and often required surgery. HCA-SAB less frequently required surgery, a minority is MRSA, and vascular device intervention (removal, sterilisation) is common. Six cases (4%) of infective endocarditis (IE) were identified; three with a history of congenital heart disease, two with CVADs in situ. There were no deaths in this cohort. CONCLUSIONS: Over an 18-year period, the proportion of SAB due to CA-MRSA and SAB associated with CVADs has increased. Categorisation of SAB as HCA and CA reveals two broad phenotypes of paediatric SAB. SAB in children is infrequently associated with IE. The health-care burden of paediatric SAB is considerable', but mortality is low. SN - 1440-1754 UR - https://www.unboundmedicine.com/medline/citation/27566273/Paediatric_Staphylococcus_aureus_bacteraemia:_A_single_centre_retrospective_cohort_ L2 - https://doi.org/10.1111/jpc.13329 DB - PRIME DP - Unbound Medicine ER -