Clinical and molecular epidemiology of staphylococcus aureus catheter-related bacteremia in children

Maria Carrillo-Marquez, Kristina G. Hulten, Edward O. Mason, Sheldon L. Kaplan

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

BACKGROUND: Staphylococcus aureus (SA) is an important cause of catheter-related bacteremia (CRB). The USA300 clone increasingly causes healthcare associated infections. We compared children with SA-CRB due to USA300 versus non-USA300 isolates and identified risk factors for complications. METHODS: Children at Texas Children's Hospital (TCH) with SA-CRB were identified from a prospective S. aureus surveillance study. S. aureus isolates were characterized by methicillin susceptibility and pulsed field gel electrophoresis. RESULTS: From August 2001 to October 2007, 112 children with a first episode of SA-CRB and corresponding isolates were identified. USA300 accounted for 21 isolates. Metastatic infection complicated 10.7% of cases and was associated with methicillin resistance. Other complications were recurrence (n = 16), death (n = 13), thrombosis (n = 9), and intravascular "cast" (n = 6). Four patients with non-USA300 SA-CRB had endocarditis. Prolonged bacteremia was more common in methicillin-resistant SA (12/29) than in methicillin-susceptible SA SA-CRB (14/83) (P = 0.007). Complications were more common in patients with bacteremia≥ 4 days (16/26 [61.5%]) versus patients with bacteremia <4 days (25/86 [29%]) (P = 0.003). The complication rate was lower in patients who had the catheter removed <4 days (22.5%) versus patients whose catheter was removed ≥ 4 days after infection or not removed (44.4%) (P = 0.02). Children with USA300 versus non-USA300 isolates did not differ with respect to frequency or type of complications. CONCLUSIONS: At Texas Children's Hospital, the USA300 clone caused 19% of initial SA-CRB episodes and was associated with methicillin resistance. Complications occurred in 36.6% of the patients and were associated with prolonged bacteremia and catheter removal 4 days after infection or failure to remove the catheter.

Original languageEnglish (US)
Pages (from-to)410-414
Number of pages5
JournalPediatric Infectious Disease Journal
Volume29
Issue number5
DOIs
StatePublished - May 1 2010

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Molecular Epidemiology
Bacteremia
Staphylococcus aureus
Catheters
Methicillin Resistance
Methicillin
Clone Cells
Infection
Pulsed Field Gel Electrophoresis
Methicillin-Resistant Staphylococcus aureus
Cross Infection
Endocarditis
Thrombosis

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Clinical and molecular epidemiology of staphylococcus aureus catheter-related bacteremia in children. / Carrillo-Marquez, Maria; Hulten, Kristina G.; Mason, Edward O.; Kaplan, Sheldon L.

In: Pediatric Infectious Disease Journal, Vol. 29, No. 5, 01.05.2010, p. 410-414.

Research output: Contribution to journalArticle

Carrillo-Marquez, Maria ; Hulten, Kristina G. ; Mason, Edward O. ; Kaplan, Sheldon L. / Clinical and molecular epidemiology of staphylococcus aureus catheter-related bacteremia in children. In: Pediatric Infectious Disease Journal. 2010 ; Vol. 29, No. 5. pp. 410-414.
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abstract = "BACKGROUND: Staphylococcus aureus (SA) is an important cause of catheter-related bacteremia (CRB). The USA300 clone increasingly causes healthcare associated infections. We compared children with SA-CRB due to USA300 versus non-USA300 isolates and identified risk factors for complications. METHODS: Children at Texas Children's Hospital (TCH) with SA-CRB were identified from a prospective S. aureus surveillance study. S. aureus isolates were characterized by methicillin susceptibility and pulsed field gel electrophoresis. RESULTS: From August 2001 to October 2007, 112 children with a first episode of SA-CRB and corresponding isolates were identified. USA300 accounted for 21 isolates. Metastatic infection complicated 10.7{\%} of cases and was associated with methicillin resistance. Other complications were recurrence (n = 16), death (n = 13), thrombosis (n = 9), and intravascular {"}cast{"} (n = 6). Four patients with non-USA300 SA-CRB had endocarditis. Prolonged bacteremia was more common in methicillin-resistant SA (12/29) than in methicillin-susceptible SA SA-CRB (14/83) (P = 0.007). Complications were more common in patients with bacteremia≥ 4 days (16/26 [61.5{\%}]) versus patients with bacteremia <4 days (25/86 [29{\%}]) (P = 0.003). The complication rate was lower in patients who had the catheter removed <4 days (22.5{\%}) versus patients whose catheter was removed ≥ 4 days after infection or not removed (44.4{\%}) (P = 0.02). Children with USA300 versus non-USA300 isolates did not differ with respect to frequency or type of complications. CONCLUSIONS: At Texas Children's Hospital, the USA300 clone caused 19{\%} of initial SA-CRB episodes and was associated with methicillin resistance. Complications occurred in 36.6{\%} of the patients and were associated with prolonged bacteremia and catheter removal 4 days after infection or failure to remove the catheter.",
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N2 - BACKGROUND: Staphylococcus aureus (SA) is an important cause of catheter-related bacteremia (CRB). The USA300 clone increasingly causes healthcare associated infections. We compared children with SA-CRB due to USA300 versus non-USA300 isolates and identified risk factors for complications. METHODS: Children at Texas Children's Hospital (TCH) with SA-CRB were identified from a prospective S. aureus surveillance study. S. aureus isolates were characterized by methicillin susceptibility and pulsed field gel electrophoresis. RESULTS: From August 2001 to October 2007, 112 children with a first episode of SA-CRB and corresponding isolates were identified. USA300 accounted for 21 isolates. Metastatic infection complicated 10.7% of cases and was associated with methicillin resistance. Other complications were recurrence (n = 16), death (n = 13), thrombosis (n = 9), and intravascular "cast" (n = 6). Four patients with non-USA300 SA-CRB had endocarditis. Prolonged bacteremia was more common in methicillin-resistant SA (12/29) than in methicillin-susceptible SA SA-CRB (14/83) (P = 0.007). Complications were more common in patients with bacteremia≥ 4 days (16/26 [61.5%]) versus patients with bacteremia <4 days (25/86 [29%]) (P = 0.003). The complication rate was lower in patients who had the catheter removed <4 days (22.5%) versus patients whose catheter was removed ≥ 4 days after infection or not removed (44.4%) (P = 0.02). Children with USA300 versus non-USA300 isolates did not differ with respect to frequency or type of complications. CONCLUSIONS: At Texas Children's Hospital, the USA300 clone caused 19% of initial SA-CRB episodes and was associated with methicillin resistance. Complications occurred in 36.6% of the patients and were associated with prolonged bacteremia and catheter removal 4 days after infection or failure to remove the catheter.

AB - BACKGROUND: Staphylococcus aureus (SA) is an important cause of catheter-related bacteremia (CRB). The USA300 clone increasingly causes healthcare associated infections. We compared children with SA-CRB due to USA300 versus non-USA300 isolates and identified risk factors for complications. METHODS: Children at Texas Children's Hospital (TCH) with SA-CRB were identified from a prospective S. aureus surveillance study. S. aureus isolates were characterized by methicillin susceptibility and pulsed field gel electrophoresis. RESULTS: From August 2001 to October 2007, 112 children with a first episode of SA-CRB and corresponding isolates were identified. USA300 accounted for 21 isolates. Metastatic infection complicated 10.7% of cases and was associated with methicillin resistance. Other complications were recurrence (n = 16), death (n = 13), thrombosis (n = 9), and intravascular "cast" (n = 6). Four patients with non-USA300 SA-CRB had endocarditis. Prolonged bacteremia was more common in methicillin-resistant SA (12/29) than in methicillin-susceptible SA SA-CRB (14/83) (P = 0.007). Complications were more common in patients with bacteremia≥ 4 days (16/26 [61.5%]) versus patients with bacteremia <4 days (25/86 [29%]) (P = 0.003). The complication rate was lower in patients who had the catheter removed <4 days (22.5%) versus patients whose catheter was removed ≥ 4 days after infection or not removed (44.4%) (P = 0.02). Children with USA300 versus non-USA300 isolates did not differ with respect to frequency or type of complications. CONCLUSIONS: At Texas Children's Hospital, the USA300 clone caused 19% of initial SA-CRB episodes and was associated with methicillin resistance. Complications occurred in 36.6% of the patients and were associated with prolonged bacteremia and catheter removal 4 days after infection or failure to remove the catheter.

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