Abstract
Background Staphylococcus aureus is an important pathogen in paediatric patients with bloodstream infections. The epidemiology of S. aureus bacteraemia, however, has not been well documented in children in South Africa.MethodsA retrospective study was conducted at a children’s hospital in Cape Town, South Africa, to investigate the epidemiology of S. aureus bacteraemia from 2007-2011. The incidence, clinical presentation, risk factors, management and outcomes of methicillin sensitive S. aureus (MSSA) and methicillin resistant S. aureus (MRSA) bacteraemia were compared.ResultsOver the five year study period, 365 episodes of S. aureus bacteraemia were identified. The annual incidence was 3.28 cases per 1000 hospital admissions. MRSA was responsible for 26% of S. aureus bacteraemia and 72% of nosocomial infections. Only six possible cases of community-acquired MRSA infections were described. MSSA bacteraemia was more likely to present as pulmonary and bone or joint infections, while bacteraemia without a source was the most common presentation with MRSA. Infants, children with malnutrition, and residents of long-term care facilities were at highest risk for MRSA bacteraemia. The overall case fatality rate for S. aureus bacteraemia was 8.8% over five years, with MRSA being the only significant risk factor for mortality.ConclusionThe incidence of S. aureus bacteraemia and MRSA bacteraemia in children has remained stable over the past five years. MRSA is a predominantly nosocomial pathogen in children with S. aureus bacteraemia in Cape Town, South Africa.
Highlights
Staphylococcus aureus is a major human pathogen that causes a wide variety of illnesses ranging from skin and soft tissue infections to life-threatening invasive disease
In Cape Town, 11.6% of bacteraemia in hospitalized children were due to S. aureus, while in specific cohorts of HIV-positive children, 10.6%, 11% and 15.7% of bacteraemic events were caused by S. aureus [1,2,3,4]
Methicillin resistant S. aureus (MRSA) is one of the commonest causes of healthcare-associated and nosocomial infection amongst adults and children worldwide, and the proportion of methicillin resistant S. aureus (MRSA) has been increasing over the last few years [5]
Summary
Staphylococcus aureus is a major human pathogen that causes a wide variety of illnesses ranging from skin and soft tissue infections to life-threatening invasive disease. This highly adaptive organism is a significant source of bacteraemia, responsible for both community-acquired and nosocomial infections. Methods: A retrospective study was conducted at a children’s hospital in Cape Town, South Africa, to investigate the epidemiology of S. aureus bacteraemia from 2007-2011. The overall case fatality rate for S. aureus bacteraemia was 8.8% over five years, with MRSA being the only significant risk factor for mortality. MRSA is a predominantly nosocomial pathogen in children with S. aureus bacteraemia in Cape Town, South Africa
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