Clinical Characteristics and Drug Resistance Characteristics of Staphylococcus Aureus Causing Bloodstream Infections in Children / 中山大学学报(医学科学版)

ABSTRACT

@#【Objective】To study the clinical characteristics，predisposing factors，prognosis and drug resistance of Staphylococcus aureus（SA）blood influenza infection in children，so as to provide basis for reasonable control and treatment of this disease.【Methods】182 cases of Staphylococcus aureus positive in blood culture from January 2016 to June 2018 were analyzed in terms of department distribution，infection type，basic diseases，clinical characteristics，antibiotic resistance，treatment outcome and prognostic factors. 【Results】 Staphylococcus aureus in blood culture was positive in 182 cases，mainly from neonatal SA（63 cases，34.6%）orthopaedics（22 cases，12.1%），PICU（20 cases，11.0%）， hematological oncology（15 cases，8.3%），rheumatic immunology（15 cases，8.3%），and respiratory medicine（13 cases，7.1%）；source of infection：community infection（109 cases，59.9%），hospital acquired infection（73 cases，40.1%）；there were 103 cases with underlying diseases （56.6%）；the most common initial symptoms were fever in 148 cases（81.8%），and methicillin-resistant staphylococcus aureus（MRSA）was found in 141 cases（77.5%）；all staphylococcus aureus were resistant to penicillin ，ampicillin ，ampicillin/sulbactam ，ceftriaxone and clindamycin ，but no serious drug resistance was found. Prognosis：161 cases（88.5%）were cured and improved，21 cases（11.5%）were not cured and 21 cases（11.5%）died. The adverse prognostic factors were severe sepsis（χ2 = 35.613，P = 0.000）and mechanical ventilation（χ2 = 39.13，P = 0.000）.【Conclusions】Patients with underlying diseases and newborns are the predisposing factors of blood stream infection of staphylococcus aureus，while those with severe sepsis and mechanical ventilation have poor prognosis. MRSA accounts for a high proportion of blood stream infection of staphylococcus aureus，and nosocomial infection is higher than community acquired infection. When empirical treatment of severe staphylococcus aureus bloodstream infection is ineffective，the treatment should be adjusted in time to take account of MRSA infection.