Background: Staphylococcus aureus bacteremia( SAB) is a significant cause of morbidity in the setting of community acquired (CA), hospital acquired (HA) and health-care related (HCR) infections.
Methods: A retrospective study at Ruth children`s hospital in Haifa, over 14 years (2002-2015). We compared the incidence, clinical, laboratory findings and outcomes of the patients with CA, HA, HCR infections.
Results: There were 185 episodes of SAB. Males accounted for 115 episodes (62%). Mean age was 73.7 months. Annual rate was 1.48 cases/ 1000 admissions. HA, CA, HCR infections were responsible for 53% [CI 95%:45.8%-60.2%], 25%, 22% of SAB, respectively. MRSA occurred in 27 cases (15%). Three cases were attributed to CA-MRSA. CA bacteremia was more likely to present as bone or joint infection. Bacteremia without focus was the most common presentation of HA and HCR SAB. Central venous catheter (CVC) was present in 88 cases (48%), (2) cases (4%), 53 cases (54%) and 33 cases (83%) of CA, HA, HCR-SAB, respectively. Age < 6 years, CVC 48hr before bacteremia, immunodeficiency and recent surgery were the main risk factors for HA or HCR infection. CA-SAB needed more abscess drainage. HCR-SAB more frequently required surgery. HA-SAB was associated with increased length of stay (LOS) post bacteremia. SAB related mortality was 1%.
Conclusions: CA- SAB rates remained stable over the past decade. There was a significant rise in the incidence of HA-SAB, with a parallel decrease in the incidence of HCR-SAB. Although mortality is rare, S.aureus still associated with high morbidity.
