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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Inappropriate empirical antibiotic therapy was an independent risk factor of pediatric persistent S. aureus
Xingmei Wang1, Ziyao Guo1, Xi Zhang1
1Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Zhengzhou District, Chongqing, 400010, China.
Insights
Inappropriate empirical antibiotic therapy is a key risk factor for persistent Staphylococcus aureus bloodstream infection (PSBSI) in children. PSBSI in children is linked to increased metastatic infection and septic shock.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Clinical Microbiology
Background:
- Persistent Staphylococcus aureus bloodstream infection (PSBSI) is associated with increased metastatic infection and mortality in adults.
- Understanding risk factors for pediatric PSBSI is crucial for improving outcomes.
Purpose of the Study:
- To identify risk factors for pediatric PSBSI.
- To determine the correlation between pediatric PSBSI, metastatic infection, and septic shock.
Main Methods:
- Retrospective and observational study of children with S. aureus bloodstream infection from January 2016 to December 2021.
- Logistic regression model used for multivariable analyses to identify independent factors.
- Analysis of associations between PSBSI, metastatic infection, and septic shock.
Main Results:
- Inappropriate empirical antibiotic therapy was an independent risk factor for pediatric PSBSI (OR, 7.26).
- Pediatric PSBSI (OR, 6.40) and community-acquired S. aureus bloodstream infection (OR, 4.75) predicted metastatic infection.
- High Pittsburgh bacteremia scores (OR, 28.81), hypoalbuminemia (OR, 13.34), and pediatric PSBSI (OR, 5.48) were risk factors for septic shock.
Conclusions:
- Inappropriate empirical antibiotic therapy is an independent risk factor for pediatric PSBSI.
- Pediatric PSBSI is significantly associated with the development of metastatic infection and septic shock.
Abstract:
Persistent S. aureus bloodstream infection (PSBSI) increased the incidence of metastatic infection and mortality. We aimed to clarify its risk factors and correlation with metastatic infection and septic shock in children. This retrospective and observational study enrolled children with S. aureus bloodstream infection who admitted to Children's Hospital of Chongqing Medical University between January 2016 and December 2021. The logistic regression model was used for multivariable analyses to determine independent factors associated with PSBSI and clarify the effect of persistent S. aureus bloodstream infection and other factors on metastatic infection and septic shock. One hundred and twenty-seven children were included in this study retrospectively. There were thirty-two cases in the persistent S. aureus bloodstream infection group and ninety-five children in the non-persistent infection group. Multivariate logistic regression analysis indicated that inappropriate empirical antibiotic therapy (OR, 7.26; 95%CI, 2.48-21.30; P<0.01) was an independent risk factor of persistent S. aureus bloodstream infection. Persistent S. aureus bloodstream infection (OR, 6.40; 95%CI, 2.08-19.70; P<0.01) and community-acquired S. aureus bloodstream infection (OR, 4.75; 95%CI, 1.34-16.89; P=0.02) were independent predictors of metastatic infection. Pittsburgh bacteremia scores ≥ 2 (OR, 28.81; 95%CI, 5.26-157.99; P<0.01), hypoalbuminemia (OR, 13.34; 95%CI, 2.43-73.28; P<0.01) and persistent S. aureus bloodstream infection (OR, 5.48; 95%CI, 1.13-26.54; P=0.04) were independent risk factors of septic shock.
Conclusion:
Inappropriate empirical antibiotic therapy was an independent risk factor of pediatric persistent S. aureus bloodstream infection. Pediatric persistent S. aureus bloodstream infection was associated with metastatic infection and septic shock.
What Is Known:
• Pathogenic features such as Methicillin-resistant S. aureus and sources of infection such as central venous catheter related infection were risk factors of PSBSI in adults. • PSBSI increased the incidence of metastatic infection and mortality in adults.
What Is New:
• Inappropriate empirical antibiotic therapy was an independent risk factor of pediatric persistent S. aureus bloodstream infection. • Pediatric persistent S. aureus bloodstream infection was associated with metastatic infection and septic shock.
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