1514. Factors Associated with an Infectious Diseases Consultation for Pediatric Staphylococcus aureus Bacteremia

BACKGROUND: Staphylococcal aureus bacteremia is associated with substantial morbidity in children. An infectious diseases consultation is associated with decreased mortality in adults with S. aureus bacteremia, but this has not yet been shown in a pediatric population. METHODS: This was a retrospective cohort study of children <18 years old hospitalized at Children’s National Medical Center with S. aureus bacteremia between January 1, 2012 and December 31, 2016. We excluded children with polymicrobial infections, those with a concurrent culture-proven infection, and those transferred with incomplete records. Structured manual chart review was used to collect demographic information, underlying comorbidities, type of admission (ICU or non-ICU), epidemiologic classification (hospital- or community-onset), primary source of infection, and methicillin resistance (MRSA or MSSA). A multivariable logistic regression analysis was performed to identify factors associated with having an infectious diseases consultation. RESULTS: We identified 171 episodes of S. aureus bacteremia; 27.5% occurred in infants <12 months old, 65.5% occurred in males, 38% occurred in ICU patients, and 18.1% were methicillin-resistant S. aureus (MRSA). The most common primary sources of infection were musculoskeletal (38%), catheter-related (18.1%), and skin/soft-tissue infections (17%). The majority (70.2%) received an infectious diseases consultation. In univariable analysis, ID consultation was more frequent among infections with the following characteristics: non-neonates (74.2% vs. 45.8%; P = 0.007), community-acquired (78.7% vs. 45.5%; P < 0.01), no underlying comorbidities (97.0% vs. 53.3%; P < 0.001), musculoskeletal (98.5%) or endovascular (100%) source of infection, and MRSA (100%). In a multivariable logistic regression analysis, musculoskeletal infections, endovascular infections, and MRSA had significantly higher odds of receiving an infectious diseases consultation. CONCLUSION: Children with S. aureus bacteremia were more likely to receive an infectious diseases consultation if presenting with musculoskeletal infections, endovascular infections, or MRSA. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.