The Utilization of Echocardiography in Children With Staphylococcus aureus Bacteremia

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Medical Imaging

Background:

• Staphylococcus aureus bacteremia (SAB) is a serious infection in children.
• The role of echocardiography in diagnosing infective endocarditis (IE) in pediatric SAB cases is not well-defined.
• Current guidelines do not uniformly recommend echocardiography for all pediatric SAB patients.

Purpose of the Study:

• To determine the necessity and diagnostic yield of echocardiography in children diagnosed with Staphylococcus aureus bacteremia (SAB).
• To identify risk factors associated with infective endocarditis (IE) in pediatric SAB cases.
• To inform clinical practice regarding echocardiography use in pediatric SAB.

Main Methods:

• Retrospective review of 331 pediatric cases with Staphylococcus aureus bacteremia (SAB).
• Analysis of clinical data, comorbidities, bacteremia duration, and echocardiogram findings.
• Comparison of patients with and without echocardiographic evidence of infective endocarditis (IE).

Main Results:

• Only nine out of 331 pediatric SAB patients met echocardiogram criteria for infective endocarditis (IE).
• All patients diagnosed with IE had pre-existing comorbidities.
• Infective endocarditis (IE) was significantly associated with congenital heart disease and prolonged bacteremia (lasting >4 days).

Conclusions:

• Echocardiography is likely unnecessary for the routine evaluation of most pediatric patients with Staphylococcus aureus bacteremia (SAB).
• Echocardiography should be considered selectively for pediatric SAB patients with specific risk factors, such as congenital heart disease and prolonged bacteremia.
• The low incidence of IE in the studied cohort suggests a conservative approach to echocardiography in uncomplicated pediatric SAB.