Clinical Management of Staphylococcus aureus Bacteremia in Neonates, Children, and Adolescents

Pediatrics. 2020 Sep;146(3):e20200134. doi: 10.1542/peds.2020-0134. Epub 2020 Aug 5.

Abstract

Staphylococcus aureus is a common cause of community and health care-associated bacteremia, with authors of recent studies estimating the incidence of S aureus bacteremia (SAB) in high-income countries between 8 and 26 per 100 000 children per year. Despite this, <300 children worldwide have ever been randomly assigned into clinical trials to assess the efficacy of treatment of SAB. A panel of infectious diseases physicians with clinical and research interests in pediatric SAB identified 7 key clinical questions. The available literature is systematically appraised, summarizing SAB management in children in relation to these priority clinical questions. The management of neonates, children, and adolescents with SAB is predominantly based on clinical experience and trial data extrapolated from adult studies, with limited high-quality evidence available to guide management. The optimal, comprehensive management strategies for SAB in children will remain unknown until the questions outlined are answered through prospective observational cohorts and inclusion of children with SAB in clinical trials.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Age Factors
  • Algorithms
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / diagnosis
  • Bacteremia / drug therapy*
  • Bacteremia / epidemiology
  • Case-Control Studies
  • Catheter-Related Infections / etiology
  • Cephalosporins / therapeutic use
  • Child
  • Child, Preschool
  • Delphi Technique
  • Drug Administration Schedule
  • Echocardiography
  • Endocarditis, Bacterial / diagnostic imaging
  • Endocarditis, Bacterial / drug therapy
  • Glycopeptides / therapeutic use
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Injections, Intravenous
  • Methicillin-Resistant Staphylococcus aureus
  • Observational Studies as Topic
  • Penicillins / therapeutic use
  • Randomized Controlled Trials as Topic
  • Referral and Consultation
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology
  • Staphylococcus aureus* / isolation & purification
  • Vancomycin / therapeutic use
  • beta-Lactams / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Glycopeptides
  • Penicillins
  • beta-Lactams
  • Vancomycin