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Frequency of infective endocarditis among infants and children with Staphylococcus aureus bacteremia

Anne Marie Valente1, Rajiv Jain, Mark Scheurer

  • 1Department of Pediatrics, Duke University, Box 3090, Durham, NC 27710, USA. valen010@mc.duke.edu

Pediatrics
|December 17, 2004
PubMed

Insights

Infective endocarditis (IE) affects 20% of children with Staphylococcus aureus bacteremia (SAB). Congenital heart disease and multiple positive blood cultures increase IE risk in pediatric SAB patients, who face high mortality.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Staphylococcus aureus bacteremia (SAB) is a serious infection in children.
  • The risk of infective endocarditis (IE) in pediatric SAB cases is not well-established.
  • Early diagnosis and management of IE are critical for improving outcomes.

Purpose of the Study:

  • To prospectively determine the prevalence of infective endocarditis (IE) in pediatric patients diagnosed with Staphylococcus aureus bacteremia (SAB).
  • To identify risk factors associated with IE in this population.
  • To assess the mortality rates in children with SAB and IE.

Main Methods:

  • Prospective study of pediatric patients with SAB between July 1998 and June 2001.
  • Echocardiography performed on all eligible children with parental consent.
  • Classification of endocarditis using modified Duke criteria and collection of clinical data.

Main Results:

  • Of 51 children with SAB, 20% had definite or possible IE.
  • Congenital heart disease was associated with a significantly higher IE prevalence (53% vs 3%).
  • High mortality rates were observed in children with SAB, particularly those with IE (40% vs 12%).

Conclusions:

  • The prevalence of definite IE in children with SAB is approximately 12%.
  • Congenital heart disease and multiple positive blood cultures are significant risk factors for IE in pediatric SAB.
  • Mortality for children with SAB and IE is notably high, underscoring the need for vigilant diagnosis and treatment.
Abstract

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