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Clinical analysis of Staphylococcus aureus infective endocarditis in children / 中华实用儿科临床杂志
Chinese Journal of Applied Clinical Pediatrics ; (24): 1707-1710, 2019.
Article in Chinese | WPRIM | ID: wpr-823704
ABSTRACT
Objective To describe the clinical characteristics,treatment and outcomes of Staphylococcus aureus infective endocarditis (SAIE) in children.Methods One hundred and fifty-one children with infective endocarditis (IE) and treated in Shanghai Children's Medical Center of Shanghai Jiaotong University School of Medicine were retrospectively analyzed,from January 2007 to December 2017.There were 88 boys and 63 girls,the age of IE onset ranged from 1 month to 17 years [(6.27 ±4.80) years].There were 23 cases (15.2%) with infection of staphylococcus aureus,128 cases with non-Staphylococcus aureus infective endocarditis (NSAIE).The clinical characteristics,treatment and prognosis of patients between the SAIE group and the NSAIE group were analyzed and compared.Results Among the SAIE group,there were 15 boys and 8 girls,the age of IE onset ranged from 3 months to 16 years [(6.2 ±5.6) years];10 cases of them had no underlying heart disease.There was no significant difference in gender,age and previous cardiac surgery between the SAIE group and the NSAIE group (all P > 0.05).The number of patients without underlying heart disease in the SAIE group was more than that in the NSAIE group,and the difference was statistically significant [43.5 % (10/23 cases) vs.20.3 % (26/128 cases),x2 =5.762,P =0.016].Compared with the NSAIE group,the SAIE group was associated with significantly higher levels of C-reactive protein [60.0 (128.0) mg/L vs.25.0(58.0) mg/L,Z =-2.033,P =0.042],higher erythrocyte sedimentation rate [(59.3 ±43.2) mm/h vs.(39.4 ±31.5) mm/h,t =-2.283,P =0.024],and lower levels of serum albumin [30.1 (12.7) g/L vs.34.3 (8.4) g/L,Z =-2.282,P =0.022].The proportion of severe sepsis in the SAIE group was also significantly higher than that in the NSAIE group [21.7% (5/23 cases) vs.7.0% (9/128 cases),Z =5.014,P =0.045].Twelve cases (52.2%) of the SAIE group had systemic embolic events,including cerebral events (6 cases),pulmonary (2 cases),limbs (1 case),splenic (1 case),limbs and mesenteric (1 case),limbs and cerebral events (1 case).Eighteen cases in the SAIE group were treated with antibiotics combined with surgery and l case died,while 5 cases were treated with antibiotics alone,4 cases died and 1 case abandoned.The SAIE patients had a significantly higher systemic embolic rate [52.2% (12/23 cases) vs.20.3% (26/128 cases),x2 =7.978,P =0.016],neurological events rate [30.4% (7/23 cases) vs.10.9% (14/128 cases),x2 =4.669,P =0.031] and in-hospital mortality [21.7% (5/23 cases) vs.6.3% (8/128 cases),x2 =4.139,P =0.042] than those in the NSAIE group.Conclusions SAIE was most common in those without heart disease.Compared with NSAIE,SAIE is characterized by a higher prevalence of severe sepsis,major neurological events,and inpatient mortality.Timely surgery is recommended in these cases,when possible,before the occurrence of complications.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Applied Clinical Pediatrics Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Applied Clinical Pediatrics Year: 2019 Type: Article