Clinical Report: Transthoracic Echocardiography Utilization in Pediatric Patients
Overview
This study evaluated the utilization of transthoracic echocardiography (TTE) in pediatric patients with Staphylococcus aureus bacteraemia (SAB), finding that 5.6% of children undergoing TTE were diagnosed with infective endocarditis (IE), all with established risk factors.
Background
Staphylococcus aureus bacteraemia (SAB) poses a risk for developing infective endocarditis (IE), particularly in children with known risk factors. Understanding the appropriate use of TTE could optimize resource allocation and patient management.
Data Highlights
Group
TTE (n=71)
No TTE (n=30)
IE Diagnosed
4 (5.6%)
0
Median Hospital Stay (days)
17
4
Acute In-Hospital Mortality
1
0
Embolic Phenomena
75%
1.5%
Persistent Bacteraemia >72 hours
67%
4.9%
Polymicrobial Growth
50%
6%
Key Findings
70% of children with SAB underwent TTE.
IE was confirmed in 5.6% of children undergoing TTE, all with established risk factors.
The TTE group had a significantly longer median hospital stay compared to the no-TTE group (17 vs 4 days).
Embolic phenomena were significantly more common in the TTE group (75% vs 1.5%).
Persistent bacteraemia at >72 hours was observed in 67% of the TTE group compared to 4.9% in the no-TTE group.
Polymicrobial growth on blood culture was found in 50% of the TTE group versus 6% in the no-TTE group.
Clinical Implications
The findings suggest that TTE may be unnecessary in children with SAB who have no established risk factors for IE. A risk-stratified approach could help identify which patients require TTE, potentially reducing unnecessary procedures and hospital stays.
Conclusion
The study advocates for a risk-stratified approach to TTE in pediatric patients with SAB, emphasizing the need for prospective validation before routine changes in practice.
