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Staphylococcus aureus Bacteremia in Children: Antibiotic Resistance and Mortality

Oren Gordon1,2, Matan J Cohen1,3, Itai Gross4

  • 1From the Department of Clinical Microbiology and Infectious Diseases.

The Pediatric Infectious Disease Journal
|September 22, 2018
PubMed
Abstract

Insights

Pediatric Staphylococcus aureus (SA) bacteremia has low short-term mortality. Health-care associated SA bacteremia increases long-term mortality risk, but methicillin-resistant SA (MRSA) did not show increased mortality compared to methicillin-susceptible SA (MSSA).

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Staphylococcus aureus (SA) bacteremia is a significant pediatric concern.
  • Methicillin-resistant SA (MRSA) poses a public health threat, yet its impact on pediatric prognosis compared to methicillin-susceptible SA (MSSA) is unclear.

Purpose of the Study:

  • To compare the prognosis of pediatric bacteremia caused by MSSA versus MRSA.
  • To identify risk factors for mortality in children with SA bacteremia.

Main Methods:

  • Retrospective analysis of pediatric SA bacteremia cases (0-16 years) from 2002-2016.
  • Classification of bacteremia as community-associated (CA) or health-care associated (HA) based on culture timing and hospitalization history.
  • Multivariable analysis to assess mortality risk, controlling for demographics, admitting department, and prior morbidity.

Main Results:

  • A total of 427 SA bacteremia events were recorded; 66% were HA.
  • In-hospital, 30-day, and 1-year mortality rates were 3%, 3.5%, and 12%, respectively.
  • HA-SA bacteremia (HR 4.1) and prior chronic disease (HR 3.4) were associated with increased 1-year mortality, while MRSA was not independently associated with increased mortality compared to MSSA (HR 1.4).

Conclusions:

  • Short-term mortality for pediatric SA bacteremia is low.
  • Health-care associated SA bacteremia and chronic conditions elevate long-term mortality risk.
  • MRSA bacteremia did not demonstrate increased mortality compared to MSSA, supporting current empiric treatment guidelines in Israel for CA bacteremia.

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