Article in Japanese

Clinical characteristics of Staphylococcus aureus bloodstream infections in children

Fumihiro OCHI^1,2), Yumi MIZUNO¹⁾, Tomonobu AOKI¹⁾

Background: Staphylococcus aureus bloodstream infections (SABI) cause significant morbidity and mortality among children. It is important to perform appropriate early antimicrobial therapy.
The aim of this study was to assess differences in the clinical background of MSSA and MRSA bacteremia.
Methods: This retrospective study included SABI patients in Fukuoka Children's Hospital from January 2004 to December 2015. The background of MSSA／MRSA bacteremia patients was analyzed retrospectively.
Results: This retrospective study included 98 episodes of SABI in 94 patients. Forty-eight and 50 episodes were caused by MSSA and MRSA in 47 and 47 patients, respectively. The median age at initial positive blood culture was 4.2 years [interquartile range (IQR), 8 days-20 years] and 1.0 year (IQR, 10 days-26 years) in the MSSA and MRSA group, respectively. The proportion of patients with underlying medical conditions, surgical history, hospitalization history, or hospital-acquired in the MRSA group was significantly larger than that in the MSSA group (p<0.001). Acute osteomyelitis (MSSA: 25%, MRSA: 2%) and mediastinitis (MSSA: 4%, MRSA: 28%) were the most common foci identified as bacteremia in the MSSA and MRSA group, respectively. Overall mortality was 9% (9／98), and this outcome was similar between patients in the MSSA and MRSA group (p=0.803). Eighty nine percent of the children had underlying medical conditions.
Conclusions: These findings indicate that antimicrobials with anti-MRSA activity should be considered as empirical therapy for SABI patients with underlying medical conditions, surgical history, hospitalization history, or hospital-acquired.

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1) Department of Pediatric Infectious Diseases, Fukuoka Children's Hospital
2) Department of Pediatrics, Ehime University Graduate School of Medicine

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Received	April 26, 2016
Accepted	August 29, 2016

28 (4)：249─255,2017