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Enhanced surveillance of Staphylococcus aureus bacteraemia to identify targets for infection prevention.
J Hosp Infect 2016; 93(2):169-74JH

Abstract

BACKGROUND

Surveillance of Staphylococcus aureus bacteraemia (SAB) in Scotland is limited to the number of infections per 100,000 acute occupied bed-days and susceptibility to meticillin.

AIM

To demonstrate the value of enhanced SAB surveillance to identify targets for infection prevention.

METHODS

Prospective cohort study of all patients identified with SAB over a five-year period in a single health board in Scotland. All patients were reviewed at the bedside by a clinical microbiologist.

FINDINGS

In all, 556 SAB episodes were identified: 261 (46.6%) were hospital-acquired; 209 (37.9%) were healthcare-associated; 80 (14.4%) were community-acquired; and in six (1.1%) the origin of infection was not hospital-acquired, but could not be separated into healthcare-associated or community-acquired. These were classified as non-hospital-acquired. Meticillin-resistant S. aureus (MRSA) bacteraemia was associated with hospital-acquired and healthcare-associated infections. In addition, there was a significantly higher 30-day mortality associated with hospital-acquired (31.4%) and healthcare-associated (16.3%) infections compared to community-acquired SAB (8.7%). Vascular access devices were associated with hospital-acquired SAB and peripheral venous cannulas were the source for most of these (43.9%). Community-acquired infections were associated with intravenous drug misuse, respiratory tract infections and skeletal and joint infections. Skin and soft tissue infections were more widely seen in healthcare-associated infections.

CONCLUSION

The data indicate that enhanced surveillance of SAB by origin of infection and source of bacteraemia has implications for infection prevention, empirical antibiotic therapy, and health improvement interventions.

Authors+Show Affiliations

Department of Clinical Microbiology and Infection Control, Victoria Hospital, Kirkcaldy, Fife, UK. Electronic address: keith.morris@nhs.net.School of Biomedical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27107617

Citation

Morris, A K., and C D. Russell. "Enhanced Surveillance of Staphylococcus Aureus Bacteraemia to Identify Targets for Infection Prevention." The Journal of Hospital Infection, vol. 93, no. 2, 2016, pp. 169-74.
Morris AK, Russell CD. Enhanced surveillance of Staphylococcus aureus bacteraemia to identify targets for infection prevention. J Hosp Infect. 2016;93(2):169-74.
Morris, A. K., & Russell, C. D. (2016). Enhanced surveillance of Staphylococcus aureus bacteraemia to identify targets for infection prevention. The Journal of Hospital Infection, 93(2), pp. 169-74. doi:10.1016/j.jhin.2016.03.003.
Morris AK, Russell CD. Enhanced Surveillance of Staphylococcus Aureus Bacteraemia to Identify Targets for Infection Prevention. J Hosp Infect. 2016;93(2):169-74. PubMed PMID: 27107617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enhanced surveillance of Staphylococcus aureus bacteraemia to identify targets for infection prevention. AU - Morris,A K, AU - Russell,C D, Y1 - 2016/03/22/ PY - 2015/10/15/received PY - 2016/03/03/accepted PY - 2016/4/25/entrez PY - 2016/4/25/pubmed PY - 2017/2/28/medline KW - Bacteraemia KW - Epidemiology KW - Outcome KW - Staphyloccocus aureus KW - Surveillance SP - 169 EP - 74 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 93 IS - 2 N2 - BACKGROUND: Surveillance of Staphylococcus aureus bacteraemia (SAB) in Scotland is limited to the number of infections per 100,000 acute occupied bed-days and susceptibility to meticillin. AIM: To demonstrate the value of enhanced SAB surveillance to identify targets for infection prevention. METHODS: Prospective cohort study of all patients identified with SAB over a five-year period in a single health board in Scotland. All patients were reviewed at the bedside by a clinical microbiologist. FINDINGS: In all, 556 SAB episodes were identified: 261 (46.6%) were hospital-acquired; 209 (37.9%) were healthcare-associated; 80 (14.4%) were community-acquired; and in six (1.1%) the origin of infection was not hospital-acquired, but could not be separated into healthcare-associated or community-acquired. These were classified as non-hospital-acquired. Meticillin-resistant S. aureus (MRSA) bacteraemia was associated with hospital-acquired and healthcare-associated infections. In addition, there was a significantly higher 30-day mortality associated with hospital-acquired (31.4%) and healthcare-associated (16.3%) infections compared to community-acquired SAB (8.7%). Vascular access devices were associated with hospital-acquired SAB and peripheral venous cannulas were the source for most of these (43.9%). Community-acquired infections were associated with intravenous drug misuse, respiratory tract infections and skeletal and joint infections. Skin and soft tissue infections were more widely seen in healthcare-associated infections. CONCLUSION: The data indicate that enhanced surveillance of SAB by origin of infection and source of bacteraemia has implications for infection prevention, empirical antibiotic therapy, and health improvement interventions. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/27107617/Enhanced_surveillance_of_Staphylococcus_aureus_bacteraemia_to_identify_targets_for_infection_prevention_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(16)00153-5 DB - PRIME DP - Unbound Medicine ER -