ESPID Education. Kassis I. 06/07/11; 7677
Dr. Imad Kassis
Dr. Imad Kassis

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Background and Aims: The epidemiology of pediatric staphylococcal bacteremia (PSAB), particularly community-acquired (CA), has not been extensively studied. The epidemiology of PSAB in our region has not been described. This study was designed to evaluate the incidence and characteristics of PSAB in northern Israel.
Methods: A retrospective review, (January 2002- December 2005), in 7 medical centers serving the entire population of hospitalized children of northern Israel.
Results: The annual incidence of PSAB during the study period was 4.7 and 2.1/100,000, overall, and for CA- PSAB, respectively. 47/106 (44.3%) episodes were CA- PSAB (mean age 73 months); all CA isolates were methicillin-susceptible. 71% were male. 59 (55.7%) were hospital-acquired (HA), median age 15 months, mean 49 months, 8 (14%) had MRSA. Predispositions for HA-PSAB included intravascular catheter 31 (52.5%); neonates, 16 (27%); immune suppression 12 (11.3 %). Primary diagnoses among those with CA-PSAB included osteoarticular infection (26, 55.5%), skin infection (4, 8.5%), primary bacteremia (5, 10.6%), pneumonia (4, 8.5%), endocarditis (2, 4.3%), and isolated cases of pyelonephritis, necrotizing fasciitis, lymphadenitis, otitis, paronychia, intra-abdominal abscess. In 5 (4.6%) there was a history of staphylococcal infection in a family member. Average duration of total antibiotic treatment was 24.6 days. There were no deaths directly related to staphylococcal bacteremia in the study group.
Conclusions: CA-PSAB occurs rarely and is associated with bone, joint and skin disease. CA-MRSA was not isolated during the study period. Groups at risk for HA-PSAB included mainly neonates especially post complicated delivery, immune suppressed patients, and those with intravascular lines.
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