Clinical variables and Staphylococcus aureus virulence factors associated with venous thromboembolism in children.
Thromb Res
; 138: 69-73, 2016 Feb.
Article
em En
| MEDLINE
| ID: mdl-26709039
ABSTRACT
OBJECTIVES:
Children with Staphylococcus aureus (SA) bacteremia risk developing venous thromboembolism (VTE). We sought to identify clinical variables and bacterial virulence factors associated with VTE in SA bacteremia. STUDYDESIGN:
This is a single-institution retrospective study of 229 children with SA bacteremia hospitalized from 2005 to 2008. Clinical data were abstracted from patient charts. Two-hundred three SA isolates were analyzed by polymerase chain reaction. The Pediatric Health Information System (PHIS) database was queried to identify subjects with a central venous line (CVL) or complex chronic conditions (CCC). Logistic regression analysis was employed to determine which factors most greatly influenced VTE.RESULTS:
VTE was present in 9.2% (n=21/229). Superficial thrombi were excluded. Mortality was greater in patients with VTE [24% vs. 6% (p=0.016)]. Among SA isolates available for virulence testing, the majority (70%; n=139) were methicillin-sensitive SA (MSSA). Methicillin-resistant SA (MRSA) infection was associated with VTE (p=0.01). The most common sites of thrombosis were extremity deep vein (58%; n=14/24), head/neck (29%; n=7), and visceral (13%; n=3). One subject had a pulmonary embolism. The presence of a CVL or a CCC was not associated with VTE. Independent predictors of VTE were C-reactive protein (CRP)≥20mg/dl [OR 4.2, 95% CI 1.16-15.25] and hemoglobin nadir ≤9g/dl [OR 5.2, 95% CI 1.3-20.64].CONCLUSIONS:
In addition to MRSA infection, CRP≥20mg/dl and hemoglobin nadir ≤9g/dl were associated with VTE in SA bacteremia. These factors may serve as markers for increased risk of VTE with invasive SA disease.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções Estafilocócicas
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Staphylococcus aureus
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Bacteriemia
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Tromboembolia Venosa
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article