DISCUSSION
S aureus is a serious, common cause of bacteremia
in modern medical practice. Although rates of IE in
adults who develop SAB is well documented,1,2 its
frequency in pediatric populations is less well characterized.
The present investigation represents the
largest prospective cohort study evaluating children
with SAB using both clinical characteristics and
transthoracic echocardiography. This investigation
yielded several key findings.
First, 20% of the patients in this study had definite
or possible IE. Previous studies of the rates of IE in
children with SAB have reported varying results.7,8
One recent investigation demonstrated that the rate
of endocarditis among 56 South African children
with SAB was 11%.3 However, the generalizability of
these results is limited, because patient and treatment
characteristics in this developing region are
likely to differ widely from current practice conditions
encountered by practitioners in industrialized
nations. The current investigation characterizes the
nature of S aureus infection in children hospitalized
in a large tertiary care center. One striking finding is
that 9 of the 10 children with endocarditis had an