Changing Epidemiology of Pediatric SAB in Denmark From 1971 Through 2000

蓝鱼o_0

Changing Epidemiology of Pediatric Staphylococcus aureus Bacteremia in Denmark From 1971 Through 2000

Background: Staphylococcus aureus is known to be a leading cause
of bacteremia in childhood, and is associated with severe morbidity
and increased mortality. To determine developments in incidence
and mortality rates, as well as risk factors associated with outcome,
we analyzed data from 1971 through 2000.
Methods: Nationwide registration of S. aureus bacteremia (SAB)
among children and adolescents from birth to 20 years of age was
performed. Data on age, sex, source of bacteremia, comorbidity and
outcome were extracted from discharge records. Rates were population
adjusted and risk factors for death were assessed by multivariate
logistic regression analysis.
Results: During the 30-year study period, 2648 cases of SAB were
reported. Incidence increased from 4.6 to 8.4 cases per 100,000
population and case-mortality rates decreased from 19.6% to 2.5%
(P
0.0001). Incidence in the infant age group (1 year) were 10-
to 17-fold greater compared with that in the other age strata and
mortality rate was twice as high. Hospital-acquired infections dominated
the infant group, accounting for 73.9%–91.0% versus 39.2%–
50.5% in the other age groups. By multivariate analysis, pulmonary
infection and endocarditis for all age groups, comorbidity for the
older than 1 year, and hospital-acquired infections for the oldest
group were independently associated with an increased risk of death.
Conclusions: Mortality rates associated with SAB decreased significantly
in the past 3 decades, possibly because of new and improved
treatment modalities. However, incidence rates have increased significantly
in the same period, underscoring that S. aureus remains an
important invasive pathogen.