725Staphylococcus aureus Bacteremia in Children: A Retrospective Review at a Tertiary Care Hospital
Bibliographic record
Abstract
Background. While Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality in adults, less is known about this condition in children. The objective of this study was to describe the characteristics, source, treatment and outcomes of children with SAB in an era when methicillin-resistant Staphylococcus aureus(MRSA) rates are increasing. Methods. All children presenting to the Hospital for Sick Children, Toronto, between April 1, 2007 and April 1, 2010 with ≥1 positive blood culture for Staphylococcus aureus were included in the study. Charts were retrospectively reviewed as part of a multicenter study on SAB management in adults and children. SAB that developed after 48 hours was considered hospital acquired. Results. A total of 147 children with a median age of 3 years (IQR 0,9) were included; 51% were male. Eight (5%) patients were not admitted to hospital and are not known to have received therapy. Almost all isolates (n = 142) were methicillin-sensitive Staphylococcus aureus. The most common source was a central line (n = 72, 49%), and 14 (19%) of these patients had a second site affected. Most central line infections were hospital acquired (n = 47, 65%, p < 0.001) and the line was removed in only 43% of cases (n = 31). Other sources included osteomyelitis and septic arthritis (n = 39), pneumonia/empyema (n = 19), cellulitis (n = 12), surgical site infection (n = 11), infective endocarditis (n = 4), urinary tract infection (n = 1) and staphylococcus scalded skin syndrome (n = 1). Overall, 25% had more than one site affected. The median antibiotic treatment duration was 23 days (IQR 14, 42). Thirty-five patients (24%) received less than 1 week of IV therapy and did not present back to this hospital with treatment failure. Treatment varied widely depending on the source of infection and the admitting service. A total of five patients died, but only one was felt to be related to Staphylococcus aureus. Conclusion. SAB in children differs significantly from adults in terms of both morbidity and mortality and extrapolating treatment decisions based on adult literature may lead to inappropriate prolonged antibiotic exposure. There is significant variability in the treatment of pediatric SAB and prospective trials are needed to guide management. Disclosures. All authors: No reported disclosures.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".