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Investigating Different Clinical Manifestations of Staphylococcus aureus Infections in Childhood-Can D-Dimer and
Pınar Önal1, Gözde Apaydın Sever1, Beste Akdeniz Eren1
1Department of Pediatric Infectious Diseases, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey.
Insights
Pediatric Staphylococcus aureus infections can lead to deep tissue complications. Elevated D-dimer and fibrinogen levels, along with community-acquired infections, are key indicators of severe cases.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Bacterial Pathogenesis
Background:
- Staphylococcus aureus is a major cause of pediatric infections, with potential for severe deep tissue involvement.
- Identifying risk factors for deep tissue infections is crucial for timely intervention in children.
Purpose of the Study:
- To evaluate clinical features of pediatric S. aureus infections.
- To identify risk factors associated with deep tissue involvement in these infections.
Main Methods:
- Retrospective study of pediatric patients (1 month-18 years) with S. aureus isolated from blood, pus, or joint fluid.
- Analysis of clinical data, laboratory results, and identification of risk factors using a decision tree model.
Main Results:
- 22.9% of patients had deep tissue infections, commonly osteoarticular, pyomyositis, or pulmonary.
- Deep-seated infections were linked to community-acquired cases and persistent positive blood cultures (>72h).
- Elevated C-reactive protein, sedimentation rate, D-dimer, and fibrinogen were significantly higher in deep-seated infections.
Conclusions:
- Community-acquired S. aureus infections, persistent bacteremia, and methicillin-susceptible S. aureus (MSSA) strains are associated with deep-seated infections.
- Elevated D-dimer (>1.15 mg/L) and fibrinogen (>334 mg/dL) are valuable early markers for deep-seated pediatric S. aureus infections.
Abstract:
Background: Staphylococcus aureus is a significant pathogen causing both local and systemic infections in children, with deep tissue involvement leading to severe complications. This study aimed to assess clinical manifestations and identify risk factors for deep tissue involvement in pediatric S. aureus infections. Methods: All children between 1 month and 18 years who had S. aureus growth in blood, pus, or joint fluid culture were included. Results: A total of 61 patients (median age 55 months) were included, with 22.9% having deep tissue infections. Osteoarticular infections, pyomyositis, and pulmonary involvement were common. Deep-seated infections were significantly associated with community-acquired infections and positive hemocultures after 72 h (p < 0.01). Laboratory results showed significantly higher levels of C-reactive protein, sedimentation rate, D-dimer, and fibrinogen in the group with deep-seated infections (p = 0.02, p = 0.018, p = 0.01, and p = 0.015, respectively). The decision tree model showed that the first indicator of deep-seated infection was a D-dimer level above 1.15 mg/L, followed by a fibrinogen level above 334 mg/dL. Conclusions: Deep-seated S. aureus infections are more frequently associated with community-acquired cases, persistent hemoculture positivity, and methicillin-susceptible Staphylococcus aureus (MSSA) strains. Additionally, elevated D-dimer and fibrinogen levels may serve as valuable markers for identifying deep-seated infections in pediatric patients.
