What factors predict staphylococcal bacteraemia in paediatric patients?

The epidemiology of organisms associated with bacteraemia is similar between paediatric or adolescent patients and adults, but the risk factors differed from that seen in the population, reports a study.

The authors sought to identify primary causative agents of bacteraemia in paediatric and adolescent patients and associated risk factors, at the same time hypothesizing that these would be different than those seen in adults.

Patients aged <18 years admitted to a tertiary referral centre from 1 January 2013 and 31 December 2015 and had a confirmed positive blood culture were included in this retrospective cohort, epidemiologic evaluation. The first positive culture per organism per patient was then analysed.

Determining the most frequent causative organisms of bacteraemia was the primary outcome measure, while the secondary one was an evaluation of risk factors for acquiring staphylococcal bacteraemia.

Of the 913 isolates examined, 92 were unique organisms. Staphylococcus epidermidis (238/913, 26.1 percent) was the most frequently identified organism, followed by Staphylococcus aureus (136/913, 14.9 percent). Methicillin resistance occurred in 60.3 percent of S aureus.

The risk factor analysis included 256 patients. Prematurity (p<0.001), previous antibiotics (p<0.001), and intubation/ventilation (p=0.032) were found to be associated with S epidermidis. Moreover, patients with a recent or previous hospitalization (p<0.001) and those with eczema/dermatitis (p=0.029) were more likely to develop S aureus.

“Further understanding of these risk factors may be helpful in developing pre-emptive infection control strategies in patients at risk,” the authors said.