Bacteraemia due to Staphylococcus aureus

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Arch Dis Child 2004;89:568–571. doi: 10.1136/adc.2003.026781

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.