Staphylococcus aureus bacteraemia in children:: A 5-year retrospective review

Objective: The clinical presentation of Staphyloccocus aureus bacteraemia has been well described in adults, but there is a paucity of published data on the presentation of S. aureus bacteraemia in children. This review sought to compare the presentation of S. aureus in children with that of adults. Methods: We conducted a 5-year retrospective chart review of S. aureus bacteraemia at the Royal Alexandra Hospital for Children between 1994 and 1998. Results: Of the 140 episodes of S. aureus bacteraemia, 53% were community acquired and 47% nosocomially acquired. The clinical presentation of S. aureus bacteraemia in the children in the present study differed significantly from published studies of adult patients. Of children with community-acquired bacteraemia without pre-existing medical conditions, 59% had a bone or joint infection, which is higher than adult series. Endocarditis has been associated with up to 30% of community-acquired bacteraemia in adults but was much less frequent (1.4%) in the present study. Despite the infrequent use of empiric antibiotic therapy (34% of episodes), the case fatality rate (1.4%) was significantly lower than the published literature relating to adults (11-32%). Conclusion: The present study highlights the differences between S. aureus bacteraemia in adults and children.