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Updated: Feb 4, 2026
Development and Assessment of Intracellular Infection Models for Staphylococcus aureus
Published on: January 17, 2025
Staphylococcus aureus Bacteremia in Children Aged 5-18 Years-Risk Factors in the New Millennium
Louise Bruun Oestergaard1, Michelle D S Schmiegelow2, Niels E Bruun3
1The Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark; The Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark.
Insights
Staphylococcus aureus bacteremia is rare in children aged 5-18. High-risk conditions like dialysis, organ transplant, and cancer significantly increase infection rates, but prematurity and socioeconomic status do not. Approximately one-third of infected children appear healthy.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Staphylococcus aureus bacteremia (SAB) is a serious infection, but its epidemiology in children aged 5-18 years with mature immune systems is less understood.
- Identifying risk factors in this age group is crucial for targeted prevention and management strategies.
Purpose of the Study:
- To investigate the association between various comorbidities and the incidence of Staphylococcus aureus bacteremia in children aged 5-18 years.
- To identify factors contributing to SAB in presumably healthy children within this age range.
Main Methods:
- A nationwide registry-based cohort study included children born from 1995 onwards, followed from age 5 or immigration date between 2000-2015.
- Poisson regression models were used to calculate incidence rate ratios (IRR) comparing children with preselected exposures to those without.
- Microbiologically verified SAB cases were analyzed, with a focus on identifying associations with comorbidities and healthcare exposures.
Main Results:
- The study followed 1,109,169 children, identifying 307 cases of SAB (incidence rate: 3.7 per 100,000 person-years).
- The highest IRRs were observed in children undergoing dialysis (IRR=367.2), organ transplantation (IRR=149.5), and those with cancer (IRR=102.9).
- Other significant risk factors included chromosomal anomalies, atopic dermatitis, congenital heart disease, and recent surgery. Notably, 37.1% of infected children had no known comorbidities or recent healthcare contact.
Conclusions:
- S. aureus bacteremia is uncommon in children aged 5-18, with established adult risk factors like dialysis, transplantation, and cancer showing the highest associated rates.
- Prematurity and parental socioeconomic status were not linked to increased SAB rates in this cohort.
- A significant proportion of children with SAB were considered healthy, highlighting the need for further research into community-acquired infections in this age group.
Objectives:
To assess the association between comorbidities and Staphylococcus aureus bacteremia in children aged 5-18 years, thus, in children with a matured immune system. Further, we aimed to identify presumably healthy children acquiring bacteremia.
Study Design:
By cross-linking nationwide registries, we consecutively included all children born from 1995 onward at their 5-year birthday or date of immigration during 2000-2015. We examined incidence rate ratios (IRR) between preselected exposures and microbiologically verified S aureus bacteremia (reference = children without exposure) using Poisson regression models.
Results:
We followed 1 109 169 children in 2000-2015 during which 307 children (incidence rate: 3.7 per 100 000 person-years) acquired S aureus bacteremia (methicillin-resistant S aureus = 8; 2.6%). Children without known comorbidities or recent contact with the healthcare system comprised 37.1% of infected children. The highest IRRs were observed in children undergoing dialysis or plasmapheresis (IRR = 367.2 [95% CI) = 188.5-715.3]), children with organ transplantation (IRR = 149.5 [95% CI = 73.9-302.2]), and children with cancer (IRR = 102.9 [95% CI = 74.4-142.2]). Positive associations also were observed in children with chromosomal anomalies (IRR = 7.16 [95% CI = 2.96-17.34]), atopic dermatitis (IRR = 4.89 [95% CI = 3.11-7.69]), congenital heart disease (IRR = 3.14 [95% CI = 1.92-5.11]), and in children undergoing surgery (IRR = 3.34 [95% CI = 2.59-4.28]). Neither premature birth nor parental socioeconomic status was associated with increased disease rates.
Conclusions:
S aureus bacteremia is uncommon in children between 5 and 18 years of age. Risk factors known from the adult population, such as dialysis, plasmapheresis, organ transplantation, and cancer, were associated with the highest relative rates. However, prematurity and parental socioeconomic status were not associated with increased rates. Approximately one-third of infected children were presumably healthy.
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