Pediatr Infect Vaccine.  2019 Apr;26(1):11-21. 10.14776/piv.2019.26.e2.

Epidemiology of Staphylococcus aureus Bacteremia in Children at a Single Center from 2002 to 2016

Affiliations
  • 1Department of Pediatrics, Gachon University College of Medicine, Gil Medical Center, Incheon, the Republic of Korea. hkcho@gilhospital.com

Abstract

PURPOSE
We aimed to investigate the epidemiological characteristics of Staphylococcus aureus bacteremia in Korean children.
METHODS
We retrospectively collected and analyzed data from the medical records of the patients with S. aureus bacteremia ≤18 years of age in Gil Medical Center from 2002 to 2016.
RESULTS
A total of 212 SAB cases were detected. The annual incidence of SAB from 2002 to 2016 ranged from 0.77 to 1.95 per 1,000 patients hospitalized. The neonate group (<28 days of age) and the pediatric group (28-18 years of age) were 51.4% (n=109) and 48.6% (n=103), respectively. According to the origin of infection, there were 93 cases (43.9%) of community-associated (CA)-SAB and 119 cases (56.1%) of healthcare-associated (HA)-SAB. The rates of HA-SAB among the neonate group and among the pediatric group were 64.2% and 47.6%, respectively (P=0.015). There was no difference in complications between CA-SAB and HA-SAB, but mortality was higher in HA-SAB. The proportion of methicillin-resistance S. aureus (MRSA) was the highest in neonates (88.1%), decreased with age, and was 36.4%-37.5% among children aged ≥5 years. The MRSA proportion was 72.2%, showing no consistent trend over the period.
CONCLUSIONS
The annual incidence of SAB and the proportion of MRSA in SAB remained constant in the recent 15 years in children. Judicious decision of antimicrobial agents for treatment considering the patient's age and the origin of infection is necessary.

Keyword

Staphylococcus aureus; Bacteremia; Methicillin-resistant Staphylococcus aureus; Infant; Child

MeSH Terms

Anti-Infective Agents
Bacteremia*
Child*
Epidemiology*
Humans
Incidence
Infant
Infant, Newborn
Medical Records
Methicillin-Resistant Staphylococcus aureus
Mortality
Retrospective Studies
Staphylococcus aureus*
Staphylococcus*
Anti-Infective Agents

Figure

  • Fig. 1. Schematic diagram to classify Staphylococcus aureus bacteremia cases included in the study. Abbreviations: CA, community associated; CO-HA, community onset-healthcare associated; HO-HA, hospital onset-healthcare associated.

  • Fig. 2. (A) The annual incidence of SAB and distribution of MSSA and MRSA among the SAB cases, (B) The annual MRSA proportion among the total SAB, CA-SAB, and HA-SAB cases. Abbreviation: SAB, Staphylococcus aureus bacteremia; MSSA, methicillin-sensitive S. aureus; MRSA, methicillin-resistant S. aureus; CA-SAB, community-associated S. aureus bacteremia; HA-SAB, healthcare-associated S. aureus bacteremia; CA-MRSA, community-associated methicillin-resistant S. aureus; HA-MRSA, healthcare-associated methicillin-resistant S. aureus.

  • Fig. 3. (A) Distribution of methicillin-resistance according to the age groups among CA-SAB. ORs in <28 days of age, 5–9 years of age, and 10–18 years of age are 8.64 (95% CI, 3.09–24.15; P=0.000), 0.09 (95% CI, 0.01–0.73; P=0.009), and 0.08 (95% CI, 0.02–0.37; P=0.000), respectively. (B) Distribution of methicillin-resistance according to the age groups among HA-SAB. ORs in <28 days group and 10–18 years group are 3.25 (95% CI, 1.19–8.89; P=0.018) and 0.21 (95% CI, 0.07–0.64; P=0.009), respectively. Abbreviations: CA-SAB, community-associated Staphylococcus aureus bacteremia; HA-SAB, healthcare-associated S. aureus bacteremia; CA-MRSA, community-associated methicillin-resistant S. aureus; CA-MSSA, community-associated methicillin-sensitive S. aureus; OR, odds ratio; CI, confidence interval. ∗P<0.05 by χ2 test.


Cited by  1 articles

Changing Susceptibility of Staphylococcus aureus in Children with Skin and Soft Tissue Infections: a Single Center Experience from 2010 to 2018
Yong-Sun Cho, Shin-Hye Lee, Taek-Jin Lee
Pediatr Infect Vaccine. 2019;26(3):140-147.    doi: 10.14776/piv.2019.26.e22.


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