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.
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.
Authors: Sebastian J van Hal; Slade O Jensen; Vikram L Vaska; Björn A Espedido; David L Paterson; Iain B Gosbell Journal: Clin Microbiol Rev Date: 2012-04 Impact factor: 26.132
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Authors: Saima Zubair; Anne Fischer; Anne Liljander; Jochen Meens; Jan Hegerman; Hadrien Gourlé; Richard P Bishop; Ina Roebbelen; Mario Younan; Mudassir Imran Mustafa; Mamoona Mushtaq; Erik Bongcam-Rudloff; Joerg Jores Journal: Stand Genomic Sci Date: 2015-11-20