J Korean Soc Neonatol.  2011 Nov;18(2):288-292. 10.5385/jksn.2011.18.2.288.

Risk Factors of Catheter-related Bloodstream Infection Due to Methicillin-resistant Staphylococcus aureus in Very Low Birth Weight Infants

• Cho IH
• Jung TW
• Lee JY
• Moon SN
• Bin JH
• Lee HS
• Lee JH
• Kim SY
• Sung IK

• KMID: 2099204
• DOI: http://doi.org/10.5385/jksn.2011.18.2.288

Abstract

PURPOSE
The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA.
METHODS
Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality.
RESULTS
Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1+/-6.6 vs. 26.9+/-20.2; P=0.005) and shorter for patients that died (10.1+/-7.0 vs. 73.0+/-32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively.
CONCLUSION
Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.

Keyword

Methicillin-resistant Staphylococcus aureus; Bacteremia; Catheter; Very low birth weight infant

MeSH Terms

Adult
Age of Onset
Arthritis
Bacteremia
C-Reactive Protein
Catheters
Central Venous Catheters
Child
Gestational Age
Humans
Incidence
Infant
Infant, Newborn
Infant, Very Low Birth Weight
Lower Extremity
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Platelet Count
Risk Factors
Sex Ratio
Soft Tissue Infections
Staphylococcus
Survivors
C-Reactive Protein