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. 2004 Jun;89(6):568–571. doi: 10.1136/adc.2003.026781

Bacteraemia due to Staphylococcus aureus

S Ladhani 1, O Konana 1, S Mwarumba 1, M English 1
PMCID: PMC1719967  PMID: 15155405

Abstract

Aims: To describe the clinical features and outcome of bacteraemia due to Staphylococcus aureus in children admitted to a rural Kenyan hospital.

Methods: Retrospective case review of all children with a positive blood culture for S aureus admitted to Kilifi District Hospital, Kenya, between January 1996 and December 2001.

Results: Ninety seven children (median age 17 months, range 1 day to 12 years; 46 male) with bacteraemia due to S aureus were identified, accounting for 5% of all positive blood cultures; 10 were considered to be nosocomially acquired. A focus that was clinically consistent with staphylococcal infection was identified in 52 cases; of these, 88% had multiple foci. Children with a focus were likely to be older, present later, and have a longer duration of hospital stay. Most children in this group (90%) received intravenous cloxacillin on admission in contrast to none of those without a focus. In the former group, mortality was only 6% compared to 47% among those without a focus; 10/13 neonates without an apparent staphylococcal focus died compared to none of the 11 with a focus. Eight of the 10 neonates in the former group died within 48 hours of admission, before empirical antibiotics could be changed to include cloxacillin.

Conclusions: Children most at risk of death associated with bacteraemia due to S aureus are least likely to have clinical features traditionally associated with this infection.

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Figure 1 .

Figure 1

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Age range of children presenting with bacteraemia due to S aureus.

Selected References

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  1. Ako-Nai A. K., Adejuyigbe E. A., Ajayi F. M., Onipede A. O. The bacteriology of neonatal septicaemia in Ile-Ife, Nigeria. J Trop Pediatr. 1999 Jun;45(3):146–151. doi: 10.1093/tropej/45.3.146. [DOI] [PubMed] [Google Scholar]
  2. Ako-Nai A. K., Taiwo O., Ebri A., Adeniran M. O. Bacterial isolates involved in cases of septicaemia in a Nigerian hospital. East Afr Med J. 1990 Jun;67(6):407–412. [PubMed] [Google Scholar]
  3. Amir M., Paul J., Batchelor B., Kariuki S., Ojoo J., Waiyaki P., Gilks C. Nasopharyngeal carriage of Staphylococcus aureus and carriage of tetracycline-resistant strains associated with HIV-seropositivity. Eur J Clin Microbiol Infect Dis. 1995 Jan;14(1):34–40. doi: 10.1007/BF02112615. [DOI] [PubMed] [Google Scholar]
  4. Dhawan A., Grover A., Marwaha R. K., Khattri H. N., Anand I. S., Kumar L., Walia B. N., Bidwai P. S. Infective endocarditis in children: profile in a developing country. Ann Trop Paediatr. 1993;13(2):189–194. doi: 10.1080/02724936.1993.11747644. [DOI] [PubMed] [Google Scholar]
  5. Espersen F., Frimodt-MØller N., Thamdrup Rosdahl V., Jessen O. Staphylococcus aureus bacteraemia in children below the age of one year. A review of 407 cases. Acta Paediatr Scand. 1989 Jan;78(1):56–61. doi: 10.1111/j.1651-2227.1989.tb10887.x. [DOI] [PubMed] [Google Scholar]
  6. Friedland I. R., du Plessis J., Cilliers A. Cardiac complications in children with Staphylococcus aureus bacteremia. J Pediatr. 1995 Nov;127(5):746–748. doi: 10.1016/s0022-3476(95)70166-4. [DOI] [PubMed] [Google Scholar]
  7. Gransden W. R., Eykyn S. J., Phillips I. Staphylococcus aureus bacteraemia: 400 episodes in St Thomas's Hospital. Br Med J (Clin Res Ed) 1984 Jan 28;288(6413):300–303. doi: 10.1136/bmj.288.6413.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Isaack H., Mbise R. L., Hirji K. F. Nosocomial bacterial infections among children with severe protein energy malnutrition. East Afr Med J. 1992 Aug;69(8):433–436. [PubMed] [Google Scholar]
  9. John R., Naraqi S., McDonnell G. The clinical spectrum of staphylococcal bacteraemia: a review of 101 Melanesian patients from Papua New Guinea. P N G Med J. 1990 Sep;33(3):229–233. [PubMed] [Google Scholar]
  10. Julander I. Unfavourable prognostic factors in Staphylococcus aureus septicemia and endocarditis. Scand J Infect Dis. 1985;17(2):179–187. doi: 10.3109/inf.1985.17.issue-2.09. [DOI] [PubMed] [Google Scholar]
  11. Lautenschlager S., Herzog C., Zimmerli W. Course and outcome of bacteremia due to Staphylococcus aureus: evaluation of different clinical case definitions. Clin Infect Dis. 1993 Apr;16(4):567–573. doi: 10.1093/clind/16.4.567. [DOI] [PubMed] [Google Scholar]
  12. Lowy F. D. Staphylococcus aureus infections. N Engl J Med. 1998 Aug 20;339(8):520–532. doi: 10.1056/NEJM199808203390806. [DOI] [PubMed] [Google Scholar]
  13. Malonza I. M., Omari M. A., Bwayo J. J., Mwatha A. K., Mutere A. N., Murage E. M., Ndinya-Achola J. O. Community acquired bacterial infections and their antimicrobial susceptibility in Nairobi, Kenya. East Afr Med J. 1997 Mar;74(3):166–170. [PubMed] [Google Scholar]
  14. Maradona J. A., Carton J. A., López-Alonso J., Cárcaba V., Nuño F. J., Arribas J. M. Comparative study of community versus hospital-acquired Staphylococcus aureus bacteraemia. Eur J Med. 1992 May;1(2):113–115. [PubMed] [Google Scholar]
  15. Michel M. F., Priem C. C., Verbrugh H. A., Goessens W. H. Staphylococcus aureus bacteremia in a Dutch teaching hospital. Infection. 1985 Nov-Dec;13(6):267–272. doi: 10.1007/BF01645436. [DOI] [PubMed] [Google Scholar]
  16. Mukonyora M., Mabiza E., Gould I. M. Staphylococcal bacteraemia in Zimbabwe 1983. J Infect. 1985 May;10(3):233–239. doi: 10.1016/s0163-4453(85)92563-0. [DOI] [PubMed] [Google Scholar]
  17. Nolan C. M., Beaty H. N. Staphylococcus aureus bacteremia. Current clinical patterns. Am J Med. 1976 Apr;60(4):495–500. doi: 10.1016/0002-9343(76)90715-4. [DOI] [PubMed] [Google Scholar]
  18. Odhiambo F. A., Wamola I. A., Ndinya-Achola J. O. Aerobic and facultative bacterial isolates from blood cultures of children with clinically diagnosed septicaemia. East Afr Med J. 1991 Nov;68(11):869–874. [PubMed] [Google Scholar]
  19. Okuonghae H. O., Nwankwo M. U., Offor E. C. Pattern of bacteraemia in febrile children with sickle cell anaemia. Ann Trop Paediatr. 1993;13(1):55–64. doi: 10.1080/02724936.1993.11747625. [DOI] [PubMed] [Google Scholar]
  20. Omari M. A., Malonza I. M., Bwayo J. J., Mutere A. N., Murage E. M., Mwatha A. K., Ndinya-Achola J. O. Pattern of bacterial infections and antimicrobial susceptibility at the Kenyatta National Hospital, Nairobi, Kenya. East Afr Med J. 1997 Mar;74(3):134–137. [PubMed] [Google Scholar]
  21. Owa J. A., Olusanya O. Neonatal bacteraemia in Wesley Guild Hospital, Ilesha, Nigeria. Ann Trop Paediatr. 1988 Jun;8(2):80–84. doi: 10.1080/02724936.1988.11748544. [DOI] [PubMed] [Google Scholar]
  22. Petit P. L., Schneeberger P., Lidala V., Butter M., Wamola I. A. Bacteriology of infections in a rural tropical area of Kenya: isolates and antibiotic susceptibility. East Afr Med J. 1991 Jul;68(7):500–506. [PubMed] [Google Scholar]
  23. Ringberg H., Thorén A., Lilja B. Metastatic complications of Staphylococcus aureus septicemia. To seek is to find. Infection. 2000 May-Jun;28(3):132–136. doi: 10.1007/s150100050065. [DOI] [PubMed] [Google Scholar]
  24. Shann F. The management of pneumonia in children in developing countries. Clin Infect Dis. 1995 Dec;21 (Suppl 3):S218–S225. doi: 10.1093/clind/21.supplement_3.s218. [DOI] [PubMed] [Google Scholar]
  25. Singhi S., Kohli V., Ayyagiri A. Bacteremia and bacterial infections in highly febrile children without apparent focus. Indian Pediatr. 1992 Oct;29(10):1285–1289. [PubMed] [Google Scholar]
  26. Snow R. W., Schellenberg J. R., Peshu N., Forster D., Newton C. R., Winstanley P. A., Mwangi I., Waruiru C., Warn P. A., Newbold C. Periodicity and space-time clustering of severe childhood malaria on the coast of Kenya. Trans R Soc Trop Med Hyg. 1993 Jul-Aug;87(4):386–390. doi: 10.1016/0035-9203(93)90007-d. [DOI] [PubMed] [Google Scholar]
  27. Steinberg J. P., Clark C. C., Hackman B. O. Nosocomial and community-acquired Staphylococcus aureus bacteremias from 1980 to 1993: impact of intravascular devices and methicillin resistance. Clin Infect Dis. 1996 Aug;23(2):255–259. doi: 10.1093/clinids/23.2.255. [DOI] [PubMed] [Google Scholar]
  28. Weinstein M. P., Reller L. B., Murphy J. R., Lichtenstein K. A. The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. I. Laboratory and epidemiologic observations. Rev Infect Dis. 1983 Jan-Feb;5(1):35–53. doi: 10.1093/clinids/5.1.35. [DOI] [PubMed] [Google Scholar]
  29. von Eiff C., Becker K., Machka K., Stammer H., Peters G. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med. 2001 Jan 4;344(1):11–16. doi: 10.1056/NEJM200101043440102. [DOI] [PubMed] [Google Scholar]

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