Factors Associated with Disease Severity in Hospitalized Children with Staphylococcus aureus Infection
Karen Linceyth Becerra Riaño, José Antonio Vargas Soler, Jhancy Rocío Aguilar-JiménezAbstract
Background
Staphylococcus aureus is a common cause of serious infections in children, with Methicillin-resistant S. aureus (MRSA) incidence rising in recent decades.
Objective
To identify the factors associated with disease severity in pediatric patients hospitalized with S. aureus infection in high-complexity institutions in Santander - Colombia.
Methods
A cross-sectional study was conducted on children under 18 years of age with S. aureus infection who were hospitalized at the International Hospital of Colombia and the Cardiovascular Foundation of Colombia between 2018 and 2021. Using bivariate analysis, clinical characteristics and outcomes were compared between MRSA and Methicillin-susceptible S. aureus (MSSA) infections. Factors associated with severity were identified through multivariate analysis with logistic and binomial regression using Stata 18.0® software.
Results
A total of 154 cases of S. aureus infection were included, 75 (48.7%) of which were MRSA. Among community-acquired infections, 55.7% (44/79) were MRSA, while 41.3% (31/75) of hospital-acquired infections were MRSA. The highest MRSA frequency was found in cases of pneumonia (70.6%). Pediatric intensive care unit (PICU) admission was required in 55.8% of cases, and infection-attributable mortality was 1.9%. MRSA infections were associated with a greater need for vasopressor/inotropic support (PR 2.06; 95% CI 1.05-4.04; p=0.036). Persistent bacteremia was associated with an increased frequency of PICU admission (PR 1.72; 95% CI 1.19 - 2.46), mechanical ventilation (PR 8.63; 95% CI 3.16 - 23.54), and vasopressor/inotropic support (PR 11.06; 95% CI 4.59 - 26.58).
Conclusion
Persistent bacteremia was associated with increased disease severity. The prevalence of community-acquired MRSA infection in this region is high and associated with a greater risk of septic shock. These findings are valuable for guiding timely empirical antibiotic therapy.