以色列儿童金黄色葡萄球菌菌血症的流行病学：社区获得性感染与医院获得性感染或医疗保健相关感染的比较。
The epidemiology of Staphylococcus aureus bacteraemia in Israeli children: Community- vs hospital-acquired or healthcare related infections.
作者信息
Dabaja-Younis Halima, Garra Wakar, Shachor-Meyouhas Yael, Mashiach Tanya, Geffen Yuval, Kassis Imad
机构信息
Pediatric Infectious Diseases Unit, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine, Haifa, Israel.
Quality Assurance Department, Rambam Health Care Campus, Haifa, Israel.
出版信息
Acta Paediatr. 2021 Jan;110(1):210-218. doi: 10.1111/apa.15393. Epub 2020 Jun 24.
AIM
Incidences of Staphylococcus aureus bacteraemia (SAB) in Israeli children are unknown. The characteristics of SAB in children have not been evaluated.
METHODS
SAB from children aged ≤18 years old, admitted to a tertiary hospital in Israel during 2002-2015, were included. The proportional rate of SAB was calculated per 1000 admissions. SAB were classified as community acquired (CA), hospital acquired (HA) and healthcare related (HCR). Patients' characteristics, antibiotic susceptibility and outcomes were assessed in each group.
RESULTS
The rate of SAB was stable, 1.48 per 1000 admissions. HA, CA and HCR-SAB comprised 53%, 25% and 22%, respectively. Only 27/185 (14.6%) were caused by methicillin-resistant S aureus (MRSA): 22%, 6% and 5% of HA, CA and HCR-SAB, respectively. Central venous catheter, recent surgery, immunodeficiency and age <6 years were the main risk factors for HA and HCR-SAB (adjusted OR: 68.9, 7.5, 5.8 and 5.5, respectively). Treatment duration for CA was >21 days: and for HA and HCR, 14-20 days. All-cause in-hospital mortality and 30-day mortality were documented in 10 (5%) and 3 (2%) episodes, respectively.
CONCLUSION
The rate of SAB; the proportions of CA, HA and HCR-SAB; and the proportion of MRSA was stable over the years. MRSA was mainly in HA-SAB. Thirty-day mortality was rare.
目的
以色列儿童金黄色葡萄球菌菌血症（SAB）的发病率尚不清楚。儿童SAB的特征尚未得到评估。
方法
纳入2002年至2015年期间入住以色列一家三级医院的18岁及以下儿童的SAB病例。计算每1000例入院病例中SAB的比例率。SAB分为社区获得性（CA）、医院获得性（HA）和医疗保健相关（HCR）。评估每组患者的特征、抗生素敏感性和结局。
结果
SAB的发生率稳定，每1000例入院病例中有1.48例。HA、CA和HCR-SAB分别占53%、25%和22%。仅27/185（14.6%）由耐甲氧西林金黄色葡萄球菌（MRSA）引起：分别占HA、CA和HCR-SAB的22%、6%和5%。中心静脉导管、近期手术、免疫缺陷和年龄<6岁是HA和HCR-SAB的主要危险因素（调整后的OR分别为68.9、7.5、5.8和5.5）。CA的治疗持续时间>21天；HA和HCR的治疗持续时间为14 - 20天。分别有10例（5%）和3例（2%）记录了全因住院死亡率和30天死亡率。
结论
多年来SAB的发生率、CA、HA和HCR-SAB的比例以及MRSA的比例保持稳定。MRSA主要存在于HA-SAB中。30天死亡率罕见。
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