The clinical spectrum of Staphylococcus aureus infections in children admitted to Chris Hani Baragwanath Academic Hospital, South Africa: A retrospective, descriptive study

P Raphulu (née Manenzhe), J Wadula, DP Moore, KL Petersen
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Abstract

Background. Staphylococcus aureus infection is associated with considerable morbidity and mortality. There are relatively few studiesdescribing invasive S. aureus infections in children, particularly in low- and middle-income countries.Objectives. To describe the clinical spectrum and outcomes associated with S. aureus infection in children <14 years of age hospitalised atChris Hani Baragwanath Academic Hospital (CHBAH), South Africa, and to identify risk factors of invasive disease.Methods. A retrospective, descriptive study was conducted at CHBAH to define the spectrum of clinical presentation, risk factors,duration of treatment and outcomes of paediatric S. aureus infections for the period January through December 2013. Data were soughtfor all children <14 years of age.Results. Four hundred and twenty-two episodes of S. aureus infection were identified. Three hundred and forty-two (81%) infectionswere caused by methicillin-susceptible S. aureus (MSSA) and 80 (19%) by methicillin-resistant S. aureus (MRSA). Clinical data wereobtained for 286 (67.8%) cases, on which all further analyses were based. Clinical presentations for MSSA bacteraemia included skin andsoft tissue infection (45%), pneumonia (10%), meningitis (6%), bone/joint infections (5%) and urinary tract infections (3%). Five (8.3%)cases of MRSA were community-acquired. Admission to intensive care unit (ICU) was the only risk factor associated with MRSA infection(adjusted odds ratio (aOR) 125.55; 95% confidence interval (CI) 11.67 - 1 350.68). Hospital-acquired S. aureus infection was the only factorassociated with mortality on multivariate analysis (aOR 8.70; 95% CI 1.55 - 48.77).Conclusion. S. aureus is frequently isolated in paediatric bacterial infections. Closer attention to infection control would impact on MRSAand S. aureus mortality rates in our setting.
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南非克里斯哈尼巴拉格瓦纳特学术医院收治的儿童金黄色葡萄球菌感染的临床谱:一项回顾性描述性研究
背景。金黄色葡萄球菌感染与相当高的发病率和死亡率有关。描述儿童侵袭性金黄色葡萄球菌感染的研究相对较少,特别是在低收入和中等收入国家。描述南非chris Hani Baragwanath学术医院(CHBAH) 14岁住院儿童金黄色葡萄球菌感染的临床谱和相关结果,并确定侵袭性疾病的危险因素。在CHBAH进行了一项回顾性描述性研究,以确定2013年1月至12月期间儿科金黄色葡萄球菌感染的临床表现、风险因素、治疗持续时间和结果。收集了所有14岁儿童的数据。共发现422例金黄色葡萄球菌感染。其中甲氧西林敏感金黄色葡萄球菌(MSSA)感染342例(81%),耐甲氧西林金黄色葡萄球菌(MRSA)感染80例(19%)。获得286例(67.8%)的临床资料,并以此为基础进行进一步分析。MSSA菌血症的临床表现包括皮肤和软组织感染(45%)、肺炎(10%)、脑膜炎(6%)、骨/关节感染(5%)和尿路感染(3%)。5例(8.3%)为社区获得性MRSA。入住重症监护病房(ICU)是唯一与MRSA感染相关的危险因素(调整优势比(aOR) 125.55;95%置信区间(CI) 11.67 - 1 350.68)。多因素分析显示,医院获得性金黄色葡萄球菌感染是与死亡率相关的唯一因素(aOR 8.70;95% CI 1.55 - 48.77)。金黄色葡萄球菌在儿科细菌感染中经常被分离出来。在我们的环境中,更密切地关注感染控制将影响mrsa和金黄色葡萄球菌的死亡率。
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0.60
自引率
0.00%
发文量
21
审稿时长
12 weeks
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