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Archivos argentinos de pediatría
Print version ISSN 0325-0075On-line version ISSN 1668-3501
Abstract
ARAYA, Soraya et al. Prognostic factors of severity of invasive community-acquired Staphylococcus aureus infections in children. Arch. argent. pediatr. [online]. 2019, vol.117, n.6, pp.381-387. Epub Dec 01, 2019. ISSN 0325-0075. http://dx.doi.org/10.5546/aap.2019.381.
Objective
To describe the clinical characteristics of invasive Staphylococcus aureus infections inchildren and identify the prognostic factors ofseverity and mortality.
Materials and methods
Observational study in patients < 16 years old hospitalized between 2010and 2015 due to invasive S. aureus infections atthe Instituto de Medicina Tropical, in Asunción, Paraguay. Patients were distributed based onwhether or not they required admission to theintensive care unit, and clinical, laboratory, and evolutionary outcome measures werecompared.
Results
Out of the 107 included patients, 50 (47 %) developed bacteremia; 50 (47 %), pneumonia; and 21 (19 %), multifocal disease. Among the patients who were admitted tothe intensive care unit (41 %), prior antibioticuse (p < 0.05), the presence of bacteremia (p = 0.01), the presence of comorbidities (p < 0.05), and multifocal disease (p < 0.01) were more frequent. The overall mortality ratewas 15 %. The mortality-associated risk factorswere the presence, at the time of admission, of hypotension (p < 0.01), multifocal disease (p < 0.01), bacteremia (p < 0.01), leukopenia (p < 0.01), severe anemia (p < 0.01), and metabolicacidosis (p < 0.01), among others.
Conclusions
The prognostic factors of severity included prior antibiotic use, bacteremia, thepresence of comorbidities, and presentationwith multifocal disease. Mortality wassignificant; associated risk factors includedthe presence, at the time of admission, ofhypotension, multifocal disease, leukopenia, severe anemia, and metabolic acidosis.
Keywords : Staphylococcus aureus; Invasive staphylococcal infections; Children; Risk factors.