Factors associated with severity in invasive community-acquired Staphylococcus aureus infections in children: a prospective European multicentre study
Por:
Gijón M, Bellusci M, Petraitiene B, Noguera-Julian A, Zilinskaite V, Sanchez Moreno P, Saavedra-Lozano J, Glikman D, Daskalaki M, Kaiser-Labusch P, Falup-Pecurariu O, Montagnani C, Prieto L, Gene-Giralt A, Trumpulyte G, Kulecnikova I, Lepe JA, Cercenado E, Kudinsky R, Makri A, Huppertz HI, Bleotu L, Cocchi P, García-Hierro P, Vitkauskiene A, Fortuny-Guasch C, Zukovskaja V, Neth O, Santos M, Rokney A, Petra M, Lixandru R, Galli L, Guillén S, Chaves F and Rojo Conejo P
Publicada:
1 jul 2016
Ahead of Print:
21 abr 2016
Resumen:
Staphylococcus aureus is the main pathogen responsible for bone and joint infections worldwide and is also capable of causing pneumonia and other invasive severe diseases. Panton-Valentine leukocidin (PVL) and methicillin-resistant S. aureus (MRSA) have been studied as factors related with severity in these infections. The aims of this study were to describe invasive community-acquired S. aureus (CA-SA) infections and to analyse factors related to severity of disease. Paediatric patients (aged 0-16 years) who had a CA-SA invasive infection were prospectively recruited from 13 centres in 7 European countries. Demographic, clinical and microbiological data were collected. Severe infection was defined as invasive infection leading to death or admission to intensive care due to haemodynamic instability or respiratory failure. A total of 152 children (88 boys) were included. The median age was 7.2 years (interquartile range, 1.3-11.9). Twenty-six (17%) of the 152 patients had a severe infection, including 3 deaths (2%). Prevalence of PVL-positive CA-SA infections was 18.6%, and 7.8% of the isolates were MRSA. The multivariate analysis identified pneumonia (adjusted odds ratio (aOR) 13.39 (95% confidence interval (CI) 4.11-43.56); p 0.008), leukopenia at admission (< 3000/mm(3)) (aOR 18.3 (95% CI 1.3-259.9); p 0.03) and PVL-positive infections (aOR 4.69 (95% CI 1.39-15.81); p 0.01) as the only factors independently associated with severe outcome. There were no differences in MRSA prevalence between severe and nonsevere cases (aOR 4.30 (95% CI 0.68- 28.95); p 0.13). Our results show that in European children, PVL is associated with more severe infections, regardless of methicillin resistance. (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Gijón M:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Bellusci M:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Petraitiene B:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Noguera-Julian A:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Zilinskaite V:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Sanchez Moreno P:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Saavedra-Lozano J:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Glikman D:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Daskalaki M:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Kaiser-Labusch P:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Falup-Pecurariu O:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Montagnani C:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Prieto L:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Gene-Giralt A:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Trumpulyte G:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Kulecnikova I:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Lepe JA:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Cercenado E:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Kudinsky R:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Makri A:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Huppertz HI:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Bleotu L:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Cocchi P:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
García-Hierro P:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Vitkauskiene A:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Fortuny-Guasch C:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Zukovskaja V:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Neth O:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Santos M:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Rokney A:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Petra M:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Lixandru R:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Galli L:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Guillén S:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Chaves F:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
Rojo Conejo P:
Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain.
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