Changing epidemiology of pediatric Staphylococcus aureus Bacteremia in Denmark from 1971 through 2000
Changing epidemiology of pediatric Staphylococcus aureus Bacteremia in Denmark from 1971 through 2000
复制标题
DOI：
10.1097/01.inf.0000261112.53035.4c
复制
发表时间：
2007-05-01
影响因子：
3.6
通讯作者：
Benfield, Thomas
中科院分区：
文献类型：
--
作者：
Frederiksen, Marianne Sjolin;Espersen, Frank;Benfield, Thomas
背景资料：已知金黄色葡萄球菌是儿童菌血症的主要原因，并且与严重的发病率和增加的死亡率相关。为了确定发病率和死亡率的发展，以及与结局相关的风险因素，我们分析了1971年至2000年的数据。方法：在全国范围内登记S。金黄色葡萄球菌菌血症（SAB）的儿童和青少年从出生到20岁。从出院记录中提取年龄、性别、菌血症来源、合并症和结局等数据。对死亡率进行人群校正，并通过多变量logistic回归分析评估死亡风险因素。结果：在30年的研究期间，报告了2648例SAB病例。发病率从4.6例/10万上升到8.4例/10万，病死率从19.6%下降到2.5%（P = 0.0001）。婴儿年龄组（< 1岁）的发病率是其他年龄组的10至17倍，死亡率是其他年龄组的两倍。医院感染以婴幼儿为主，占73.9%~ 91.0%，其他年龄组为39.2%~ 50.5%。通过多变量分析，所有年龄组的肺部感染和心内膜炎，年龄大于1岁的合并症，以及年龄最大组的医院获得性感染与死亡风险增加独立相关。结论：过去30年，与SAB相关的死亡率显着下降，这可能是由于新的和改进的治疗方式。然而，发病率在同一时期显著增加，强调S。金黄色葡萄球菌仍然是重要的侵入性病原体。
Background: Staphylococcus aureus is known to be a leading cause of bacteremia in childhood, and is associated with severe morbidity and increased mortality. To determine developments in incidence and mortality rates, as well as risk factors associated with outcome, we analyzed data from 1971 through 2000. Methods: Nationwide registration of S. aureus bacteremia (SAB) among children and adolescents from birth to 20 years of age was performed. Data on age, sex, source of bacteremia, comorbidity and outcome were extracted from discharge records. Rates were population adjusted and risk factors for death were assessed by multivariate logistic regression analysis. Results: During the 30-year study period, 2648 cases of SAB were reported. Incidence increased from 4.6 to 8.4 cases per 100,000 population and case-mortality rates decreased from 19.6% to 2.5% (P = 0.000 1). Incidence in the infant age group (< 1 year) were 10-to 17-fold greater compared with that in the other age strata and mortality rate was twice as high. Hospital-acquired infections dominated the infant group, accounting for 73.9%-91.0% versus 39.2%50.5% in the other age groups. By multivariate analysis, pulmonary infection and endocarditis for all age groups, comorbidity for the older than I year, and hospital-acquired infections for the oldest group were independently associated with an increased risk of death. Conclusions: Mortality rates associated with SAB decreased significantly in the past 3 decades, possibly because of new and improved treatment modalities. However, incidence rates have increased significantly in the same period, underscoring that S. aureus remains an important invasive pathogen.