Morbidity and mortality of Staphylococcal bacteremia in children

Background: Staphylococcal aureus bacteremia (SAB) is a major problem in adult patients with a significant mortality. Less is known about SAB in children. The present study was designed to review a 5-year experience with SAB in a children's hospital. Methods: We conducted a retrospective chart review from 2000-2004. Results: Thirty-six children experienced 42 episodes of SAB and ranged in age from 1 week to 16.7 years with a mean age of 30.5 months. Thirty-two (89%) of the 36 children had preexisting medical conditions. Thirty-six (86%) of 42 episodes of SAB were due to hospital-acquired infections, and 22 (61%) of these 36 episodes occurred in premature infants in the neonatal intensive care unit. Only 3 episodes (7%) of endocarditis were identified, and 2 were community-acquired infections. Fourteen (39%) episodes of SAB were due to methicillin-resistant strains. There were only 3 (8%) deaths, and all were unrelated to SAB. Conclusion: SAB occurred most often as a hospital-acquired infection in the neonatal intensive care unit, and methicillin-resistant Staphylococcal aureus accounted for one third of the episodes. Complications such as endocarditis or other metastatic infections and death because of SAB were infrequent.