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Staphylococcus aureus Infections in Children With Congenital Heart Disease

J Chase McNeil1, John A Ligon2, Kristina G Hulten2

  • 1Section of Infectious Diseases and jm140109@bcm.tmc.edu.

Journal of the Pediatric Infectious Diseases Society
|December 1, 2015
PubMed

Insights

Staphylococcus aureus infections are common in children with congenital heart disease (CHD). Infective endocarditis (IE) is a frequent complication, with prolonged bacteremia and elevated CRP indicating higher risk.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Congenital heart disease (CHD) is a primary risk factor for infective endocarditis (IE) in pediatric populations.
  • Staphylococcus aureus is a leading cause of IE, yet specific risk factors for invasive S. aureus disease in children with CHD remain underexplored.

Purpose of the Study:

  • To investigate the epidemiology of Staphylococcus aureus infections in children diagnosed with congenital heart disease.
  • To identify risk factors and clinical outcomes associated with S. aureus infections in this vulnerable pediatric group.

Main Methods:

  • Retrospective review of clinical and laboratory data from pediatric patients with CHD and S. aureus infection.
  • Analysis of S. aureus isolates for the presence of the qacA/B gene, a marker for antiseptic tolerance.
  • Statistical comparison of clinical variables using Fisher's exact test and Mann-Whitney U tests.

Main Results:

  • 248 S. aureus infections occurred in 216 patients with CHD; 53.6% of isolates were methicillin-resistant.
  • Surgical site infections (28.2%) and bacteremia (20.4%) were common, with IE complicating 29.5% of bacteremic episodes.
  • Prolonged bacteremia, thrombocytopenia, and elevated C-reactive protein (CRP) were associated with IE. The qacA/B gene was detected in 16.9% of isolates, linked to bacteremia and longer hospital stays.

Conclusions:

  • Staphylococcus aureus poses a significant threat, causing substantial morbidity in children with CHD.
  • Infective endocarditis is a frequent complication of S. aureus bacteremia in this cohort. Prolonged bacteremia, thrombocytopenia, and CRP levels >10 mg/dL may aid in IE diagnosis.
  • qacA/B-positive S. aureus isolates are associated with poorer clinical outcomes, highlighting potential targets for intervention.
Abstract

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