Severe staphylococcal sepsis in adolescents

Area of Science:

• Pediatric Infectious Diseases
• Bacteriology
• Public Health

Background:

• Severe Staphylococcus aureus infections, including septicemia, bone/joint infections, and pulmonary disease, were observed in nine previously healthy children (ages 8-15) between 1972-1975.
• No predisposing factors like immunodeficiency or prior therapy were identified in these patients.
• This cluster of severe staphylococcal infections in adolescents was unprecedented in the preceding five-year period.

Purpose of the Study:

• To report a series of severe, life-threatening Staphylococcus aureus infections in healthy children.
• To investigate potential contributing factors, noting the temporal association with hexachlorophene use restrictions.

Main Methods:

• Retrospective review of clinical cases presenting with severe Staphylococcus aureus infections.
• Microbiological analysis of patient specimens including blood, joint fluid, bone, and respiratory secretions.
• Comparison of infection incidence with historical data and public health policy changes.

Main Results:

• Seven patients had bone/joint infections, and eight had pulmonary disease, often presenting as septic pulmonary emboli.
• Staphylococcus aureus was isolated from multiple sites; all isolates were methicillin-sensitive.
• One patient died from pulmonary complications; clinical response was sometimes delayed by inadequate surgical drainage.

Conclusions:

• The occurrence of severe Staphylococcus aureus infections in healthy children during this period is notable.
• A temporal correlation exists between this outbreak and the implementation of restrictions on hexachlorophene use, although direct causality is not proven.
• Prompt surgical intervention is critical for managing severe staphylococcal infections.