Epidemiology, clinical outcomes and mortality-associated factors of staphylococcal pneumonia in hospitalized Thai children: A nationwide retrospective analysis 2015-2023.
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BACKGROUND AND AIMS: Staphylococcal pneumonia is a serious cause of morbidity and mortality in children worldwide, particularly in resource-limited settings. This study aimed to investigate the national epidemiology, clinical outcomes, and mortality-associated factors of pediatric staphylococcal pneumonia in Thailand. MATERIALS AND METHODS: A nationwide retrospective study was conducted using the National Health Security Office (NHSO) database. All hospital admissions of children aged 1 month to < 18 years diagnosed with staphylococcal pneumonia (ICD-10-TM code J15.2) between 2015 and 2023 were included. Demographics, comorbidities, complications, interventions, and outcomes were analyzed. Multivariable logistic regression was used to identify factors independently associated with mortality. RESULTS: A total of 1718 admissions were analyzed. Annual admissions peaked at 249 in 2016 and were lowest at 129 in 2022. Most admissions were male (61.5 %) and infants under 1 year (34.2 %). Intubation was required in 60.9 % of cases, and 10.5 % underwent surgical interventions. The hospital mortality rate was 10.6 %. Factors associated with higher mortality included congenital heart disease (adjusted odds ratio [AOR] 3.57; 95 % CI 2.27-5.61), malignancy (AOR 4.13; 95 % CI 1.87-9.10), malnutrition (AOR 3.13; 95 % CI 1.45-6.75), acute respiratory distress syndrome (ARDS) (AOR 4.26; 95 % CI 2.23-8.14), septic shock (AOR 3.85; 95 % CI 2.52-5.90), acute renal failure (AOR 4.46; 95 % CI 2.72-7.30), disseminated intravascular coagulation (DIC) (AOR 2.13; 95 % CI 1.18-3.83), and need for endotracheal intubation (AOR 9.98; 95 % CI 4.50-22.15). CONCLUSION: Pediatric staphylococcal pneumonia remains a significant clinical burden in Thailand, with high complication and mortality rates. Targeted interventions, particularly in high-risk populations, are essential to improve outcomes.