Which factors predict persistent SAB in children?

A shorter time to culture positivity, osteoarticular infection, and higher presenting and peak values for some inflammatory markers appear predictive of persistent S. aureus bacteremia (SAB) in children, suggests a study.

A team of investigators performed a single-centre retrospective secondary analysis of a prospective observational study of paediatric patients hospitalized with S. aureus infection over 3.5 years at a large, quaternary children’s hospital.

A total of 259 children with confirmed S. aureus infection were included in the analysis. Of these, 65 were found to have bacteremia, with 28 (43 percent) developing persistent bacteremia.

Children with persistent SAB were culture-positive for a median of 3.5 days relative to just 1 day for those without (p≤0.001). Patients with persistent SAB were more likely to have an identified osteoarticular source of infection (93 percent vs 62 percent; p=0.008) and a shorter median duration to culture positivity than those without (16 vs 20 hours; p≤0.001).

“In addition, children with persistent SAB had higher median values of presenting erythrocyte sedimentation rate, peak erythrocyte sedimentation rate, presenting C-reactive protein, and peak C-reactive protein,” the investigators said.

“Not surprisingly, hospital length of stay was longer in children with persistent SAB compared with those without,” they added.

Persistent SAB potentially increases the risk of morbidity and mortality in both children and adults, according to the investigators.