The clinical spectrum of Staphylococcus Aureus infections in children admitted at Chris Hani Baragwanath Academic Hospital: a retrospective, descriptive study

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.