The clinical spectrum of Staphylococcus Aureus infections in children admitted at Chris Hani Baragwanath Academic Hospital: a retrospective, descriptive study
Date
2018
Authors
Manenzhe, Phophi
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Abstract
Introduction: Staphylococcus aureus is a virulent bacterial pathogen which is associated with considerable morbidity and mortality. There are relatively few studies describing invasive S. aureus infections in children, particularly in developing countries.
Objectives: To define the spectrum of clinical presentation, risk factors, duration of treatment and outcomes of paediatric S. aureus infections treated at Chris Hani Baragwanath Academic Hospital (CHBAH), South Africa.
Methods: A retrospective, descriptive study for the period from January to December 2013 was conducted. Data were sought for all children <14 years of age with S. aureus infection.
Results: Four hundred, twenty-two episodes of S. aureus infection were identified. Clinical data were obtained for 286 (68%) cases, on which all further analyses were based. Two-hundred, twenty-six (79%) infections were caused by methicillin-susceptible S. aureus (MSSA), and 60 (21%) were caused by methicillin-resistant S. aureus (MRSA). Clinical presentations for MSSA bacteraemia included skin and soft tissue infection (45%), pneumonia (10%), meningitis (7%), bone/joint infections (5%) and urinary tract infections (4%). Risk factors for MRSA sepsis included burns (OR 38.01; 95%CI 15.33-94.21), prematurity (OR 14.42; 95%CI 5.72-36.34), prolonged hospitalisation (OR 12.26; 95%CI 3.81-40.77), presence of indwelling device (OR 12.08; 95%CI 5.86-24.90) and malnutrition (OR 11.03; 95%CI 3.41-35.74). Five cases of MRSA were attributed to have been community-acquired.
Conclusion: Paediatric S. aureus infections are an important cause of morbidity. Most invasive S. aureus infections are caused by methicillin-susceptible strains, although MRSA should be considered particularly in the context of hospitalised patients.
Description
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Paediatrics.
Johannesburg, March 2018.