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Risk of Infective Endocarditis in Pediatric Staphylococcal Bacteremia: A 20-Year Cohort Study

Apisara Pakotiprapha1, Paweena Chungsomprasong, Chodchanok Vijarnsorn

  • 1From the Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

The Pediatric Infectious Disease Journal
|May 12, 2026
PubMed

Insights

Staphylococcus aureus endocarditis (SAE) affects 8.8% of pediatric S. aureus bacteremia (SAB) cases. Congenital heart disease, malnutrition, and persistent bacteremia are key predictors, aiding early risk identification in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology
  • Clinical Microbiology

Background:

  • Staphylococcus aureus endocarditis (SAE) prevalence in pediatric S. aureus bacteremia (SAB) is variable and less understood than in adults.
  • Early identification of SAE risk factors in children is crucial for timely intervention.

Purpose of the Study:

  • To determine the prevalence of SAE in pediatric patients with SAB.
  • To identify clinical risk factors associated with SAE in this population.

Main Methods:

  • Retrospective analysis of pediatric patients (0-18 years) with SAB from 2003-2023.
  • Diagnosis of SAE based on modified Duke criteria and 2023 ESC guidelines.
  • Statistical analysis to identify associated clinical risk factors.

Main Results:

  • SAE was diagnosed in 8.8% (15/171) of pediatric SAB cases.
  • Congenital heart disease (P=0.02), protein-energy malnutrition (PEM) (P=0.04), and >2 positive blood cultures (P=0.001) were significant risk factors.
  • Immunocompromised status showed a reduced risk (P<0.001); both SAB and SAE correlated with longer hospitalization and higher mortality.

Conclusions:

  • SAE occurs in 8.8% of pediatric SAB cases, with specific clinical predictors identified.
  • Congenital heart disease, PEM, and persistent bacteremia are key predictors for SAE in children.
  • These factors can guide early risk assessment and management decisions, especially when echocardiography is limited.
Abstract

Keywords:
bacteremiainfective endocarditispediatric

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