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Abstract
BackgroundStaphylococcus aureus (S. aureus) is a common cause of bacteremia, which leads to significant morbidity and mortality. We investigated the relationship between time to positivity (TTP) and clinical outcomes in children with S.aureus bacteremia in the China.MethodsA retrospective study of Staphylococcus aureus bacteremia inpatient was performed in Children’s Hospital of Chongqing Medical University in China between 29 January 2014 and 29 August 2017. TTP and clinical parameters were determined and analyzed. The receiver operating characteristic (ROC) curves were plotted for optimal cut-off selection, multivariate logistic regression tests were performed to evaluate the association between TTP and clinical outcomes.ResultsOverall, 84 cases were enrolled. We stated that in-hospital mortality is significantly higher in the early TTP (≤17 h) than in the late TTP (> 17 h) group (57.14% vs 7.14%, P = 0.000). Septic shock occurred in 57.14% of patients with early TTP and in 18.57% of patients with late TTP (P = 0.002). Detailed multivariate and statistical analysis revealed that early TTP, need for vasoactive agent were independent risk factors of in-hospital mortality; early TTP, need for vasoactive agent and APACHE II score ≥ 15 were independent risk factors of septic shock incidence in S. aureus bacteremia children.ConclusionsOverall, TTP of ≤17 h appeared to correlate with the worse outcomes for S. aureus bacteremia children. These results have important implications in the assessments and management of pediatric S. aureus bacteremia in a clinical setting.Trial registrationRetrospectively registered.
Highlights
Staphylococcus aureus (S. aureus) is a common cause of bacteremia, which leads to significant morbidity and mortality
Definitions Staphylococcus aureus bacteremia (SAB) was defined as at least 1 positive S. aureus blood culture with systemic inflammation reaction syndrome status (SIRS), Systemic inflammation reaction syndrome status (SIRS) was defined according to the criteria previous published on Pediatr Crit Care Med [18]
Statistical methods The continuous variables were presented as medians, and the first and third quartiles; the Student’s t test, Chi-square test, or the Mann-Whitney U test were used for analysis
Summary
Staphylococcus aureus (S. aureus) is a common cause of bacteremia, which leads to significant morbidity and mortality. We investigated the relationship between time to positivity (TTP) and clinical outcomes in children with S.aureus bacteremia in the China. Staphylococcus aureus (S. aureus) is a common cause of bloodstream infections [1] and S. aureus bacteremia (SAB) leads to significant morbidity and mortality, both in adults and children [2,3,4]. The prevalence of SAB in the pediatric populations of industrialized nations is high, ranging from 8.4 to 30/100,000 person-years [5, 6]. Li et al BMC Infectious Diseases (2019) 19:437 relationship between TTP and clinical presentations and outcomes, to explore the risk factors of in-hospital mortality, septic shock incidence in children with SAB
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