Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 23 , ISSUE 5 ( May, 2019 ) > List of Articles


Staphylococcus aureus Infection in a Pediatric ICU: A Hospital Based Prospective Observational Study

Ishtiyaq Qadri, Ishaq Malik, Kaisar Ahmed

Keywords : Mortality, MRSA, PICU, Staphylococcus aureus

Citation Information : Qadri I, Malik I, Ahmed K. Staphylococcus aureus Infection in a Pediatric ICU: A Hospital Based Prospective Observational Study. Indian J Crit Care Med 2019; 23 (5):210-212.

DOI: 10.5005/jp-journals-10071-23162

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2019; The Author(s).


Introduction: Admission to a pediatric intensive care unit (PICU) with a Staphylococcus aureus (SA) infection is associated with considerable mortality and morbidity. There is paucity of data about epidemiology of SA infection in a PICU. This study was aimed at elucidating the clinicoepidemiological profile and outcome of children admitted to ICU with S. aureus infection. Methods: This study was carried out in a PICU at a tertiary care hospital in northern India. Children admitted with culture positive S. aureus infection were enrolled in this study. Children suspected of having S. aureus infection on clinical grounds only without a positive culture were excluded from the study. Baseline characteristics of the subjects were recorded on admission and daily follow up maintained till death or discharge from PICU. The course during PICU stay, ensuing complication, and outcome was recorded. Results: There were 2,480 total admissions to the PICU during study period of one year, out of which 120 (4.83%) admissions had a culture proven S. aureus infection. Fifty-six (46.6%) were male and 64 (53.3%) were female. Most of the subjects fell in the age groups of 1–5 years and 10–15 years having 56 (46.6%) and 40 (33.3%) subjects, respectively. Pneumonia (43.3%), septicaemia (20.8), and bone/joint space infections (15%) were the three main clinical manifestations. Forty-two (35%) of specimens were reported as methicillin resistant. Incidence of methicillin resistant SA (MRSA) infection was 1.6 and that of methicillin sensitive SA (MSSA) 3.1 per 100 admissions to PICU. On sensitivity testing, none of the specimens was found to be vancomycin resistant. There were 240 total deaths in PICU during study period out of which 25 (10.4%) were observed from the study group. Mortality rate was 20.8%. Mortality was high in the MRSA group. Conclusion: The incidence of S. aureus infection and associated mortality is high in PICU. MRSA infection was more common in children admitted with chronic disease and is associated with higher mortality. Our study found a bimodal age distribution for serious staph infection, a finding that needs further evaluation.

PDF Share
  1. Laupland KB, Lyytikäinen O, Søgaard M, Kennedy KJ, Knudsen JD, Ostergaard C, et al. The changing epidemiology of Staphylococcus aureus bloodstream infection: a multinational population-based surveillance study. Clin Microbiol Infect. 2013; 19(5):465–471. doi: 10.1111/j.1469-0691.2012.03903.x
  2. Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis. 2005; 5:751–762. doi: 10.1016/ S1473-3099(05)70295-4
  3. Vanderkooi OG, Gregson DB, Kellner JD, Laupland KB. Staphylococcus aureus bloodstream infections in children: a population-based assessment. Paediatr Child Health. 2011; 16(5): 276–280.
  4. Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG. Staphylococcus aureus Infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28(3):603–661. doi: 10.1128/CMR.00134-14
  5. Song X, Cogen J, Singh N. Incidence of methicillin-resistant Staphylococcus aureus infection in a children's hospital in the Washington metropolitan area of the United States, 2003 – 2010. Emerg Microbes Infect. 2013; 2(10): e69. doi:10.1038/emi.2013.69.
  6. Gerber JS, Coffin SE, Smathers SA, Zaoutis TE. Trends in the Incidence of methicillin-resistant Staphylococcus aureus Infection in children's hospitals in the United States. Clin Infect Dis. 2009;49(1):65–71. doi: 10.1086/599348
  7. Moran GJ, Amii RN, Abrahamian FM, Talan DA. Methicillin-resistant Staphylococcus aureus in community-acquired skin infections. Emerg Infect Dis. 2005; 11(6):928–930. doi: 10.3201/eid1106.040641
  8. Sabouni F, Ranjbari R, Pourakbari B, Mahmoudi S, Teymuri M, Ashtiani MT, et al. Staphylococcus aureus infections in children in an Iranian referral pediatric Hospital. J Prev Med Hyg. 2013; 54(4): 205–207.
  9. Datta R, Huang SS. Risk of infection and death due to methicillinresistant Staphylococcus aureus in long-term carriers. Clin Infect Dis. 2008;47(2):176–181. doi: 10.1086/589241
  10. Raygada JL, Levine DP. Methicillin-resistant Staphylococcus aureus: a growing risk in the hospital and in the community. Am Health Drug Benefits. 2009; 2(2): 86–95.
  11. Otto, M. MRSA Virulence and Spread. Cell Microbiol. 2012; 14(10): 1513–1521. doi: 10.1111/j.1462-5822.2012.01832.x
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.