Cargando…

Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study

BACKGROUND: The presence of Staphylococcus aureus in the bloodstream can lead to the development of sepsis; however, the severity and risk factors of the systemic inflammatory response to Staphylococcus aureus bloodstream infections were unclear. This study is aimed to build a model to predict the r...

Descripción completa

Detalles Bibliográficos
Autores principales: Sun, Chen, Tan, Dongdong, Yu, Jiajia, Liu, Jingxian, Shen, Dihua, Li, Shuang, Zhao, Shiyong, Zhang, Liya, Li, Huajun, Cai, Kang, Xu, Shanshan, Huang, Lisu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544563/
https://www.ncbi.nlm.nih.gov/pubmed/37784062
http://dx.doi.org/10.1186/s12887-023-04317-2
_version_ 1785114527136743424
author Sun, Chen
Tan, Dongdong
Yu, Jiajia
Liu, Jingxian
Shen, Dihua
Li, Shuang
Zhao, Shiyong
Zhang, Liya
Li, Huajun
Cai, Kang
Xu, Shanshan
Huang, Lisu
author_facet Sun, Chen
Tan, Dongdong
Yu, Jiajia
Liu, Jingxian
Shen, Dihua
Li, Shuang
Zhao, Shiyong
Zhang, Liya
Li, Huajun
Cai, Kang
Xu, Shanshan
Huang, Lisu
author_sort Sun, Chen
collection PubMed
description BACKGROUND: The presence of Staphylococcus aureus in the bloodstream can lead to the development of sepsis; however, the severity and risk factors of the systemic inflammatory response to Staphylococcus aureus bloodstream infections were unclear. This study is aimed to build a model to predict the risk of sepsis in children with Staphylococcus aureus bloodstream infections. METHODS: A retrospective analysis of hospitalized pediatric patients diagnosed with Staphylococcus aureus bloodstream infections was performed between January 2013 and December 2019. Each patient was assessed using the pediatric version of the Sequential Organ Failure Assessment score (pSOFA) within 24 h of blood culture collection. A nomogram based on logistic regression models was constructed to predict the risk factors for sepsis in children with Staphylococcus aureus bloodstream infections. It was validated using the area under the receiver-operating characteristic curve (AUC). RESULTS: Of the 94 patients included in the study, 35 cases (37.2%) developed sepsis. The pSOFA scores ranged from 0 to 8, with 35 patients having a pSOFA score of ≥ 2. Six children (6.4%) died within 30 days, who were all from the sepsis group and had different pSOFA scores. The most common organs involved in sepsis in children with staphylococcal bloodstream infections were the neurologic system (68.6%), respiratory system (48.6%), and coagulation system (45.7%). Hospital-acquired infections (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.3–7.2), implanted catheters (aOR, 10.4; 95% CI, 3.8–28.4), procalcitonin level ≥ 1.7 ng/mL (aOR, 15.4; 95% CI, 2.7–87.1), and underlying diseases, especially gastrointestinal malformations (aOR, 14.0; 95% CI, 2.9–66.7) were associated with Staphylococcus aureus sepsis. However, methicillin-resistant Staphylococcus aureus infection was not a risk factor for sepsis. The nomogram had high predictive accuracy for the estimation of sepsis risk, with an AUC of 0.85. CONCLUSIONS: We developed a predictive model for sepsis in children with Staphylococcus aureus infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-023-04317-2.
format Online
Article
Text
id pubmed-10544563
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-105445632023-10-03 Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study Sun, Chen Tan, Dongdong Yu, Jiajia Liu, Jingxian Shen, Dihua Li, Shuang Zhao, Shiyong Zhang, Liya Li, Huajun Cai, Kang Xu, Shanshan Huang, Lisu BMC Pediatr Research BACKGROUND: The presence of Staphylococcus aureus in the bloodstream can lead to the development of sepsis; however, the severity and risk factors of the systemic inflammatory response to Staphylococcus aureus bloodstream infections were unclear. This study is aimed to build a model to predict the risk of sepsis in children with Staphylococcus aureus bloodstream infections. METHODS: A retrospective analysis of hospitalized pediatric patients diagnosed with Staphylococcus aureus bloodstream infections was performed between January 2013 and December 2019. Each patient was assessed using the pediatric version of the Sequential Organ Failure Assessment score (pSOFA) within 24 h of blood culture collection. A nomogram based on logistic regression models was constructed to predict the risk factors for sepsis in children with Staphylococcus aureus bloodstream infections. It was validated using the area under the receiver-operating characteristic curve (AUC). RESULTS: Of the 94 patients included in the study, 35 cases (37.2%) developed sepsis. The pSOFA scores ranged from 0 to 8, with 35 patients having a pSOFA score of ≥ 2. Six children (6.4%) died within 30 days, who were all from the sepsis group and had different pSOFA scores. The most common organs involved in sepsis in children with staphylococcal bloodstream infections were the neurologic system (68.6%), respiratory system (48.6%), and coagulation system (45.7%). Hospital-acquired infections (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.3–7.2), implanted catheters (aOR, 10.4; 95% CI, 3.8–28.4), procalcitonin level ≥ 1.7 ng/mL (aOR, 15.4; 95% CI, 2.7–87.1), and underlying diseases, especially gastrointestinal malformations (aOR, 14.0; 95% CI, 2.9–66.7) were associated with Staphylococcus aureus sepsis. However, methicillin-resistant Staphylococcus aureus infection was not a risk factor for sepsis. The nomogram had high predictive accuracy for the estimation of sepsis risk, with an AUC of 0.85. CONCLUSIONS: We developed a predictive model for sepsis in children with Staphylococcus aureus infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-023-04317-2. BioMed Central 2023-10-02 /pmc/articles/PMC10544563/ /pubmed/37784062 http://dx.doi.org/10.1186/s12887-023-04317-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Sun, Chen
Tan, Dongdong
Yu, Jiajia
Liu, Jingxian
Shen, Dihua
Li, Shuang
Zhao, Shiyong
Zhang, Liya
Li, Huajun
Cai, Kang
Xu, Shanshan
Huang, Lisu
Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study
title Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study
title_full Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study
title_fullStr Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study
title_full_unstemmed Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study
title_short Predictive models for sepsis in children with Staphylococcus aureus bloodstream infections: a retrospective cohort study
title_sort predictive models for sepsis in children with staphylococcus aureus bloodstream infections: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544563/
https://www.ncbi.nlm.nih.gov/pubmed/37784062
http://dx.doi.org/10.1186/s12887-023-04317-2
work_keys_str_mv AT sunchen predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT tandongdong predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT yujiajia predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT liujingxian predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT shendihua predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT lishuang predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT zhaoshiyong predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT zhangliya predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT lihuajun predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT caikang predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT xushanshan predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy
AT huanglisu predictivemodelsforsepsisinchildrenwithstaphylococcusaureusbloodstreaminfectionsaretrospectivecohortstudy