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.
Original language | English |
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Pages (from-to) | 169-74 |
Number of pages | 6 |
Journal | Journal of Hospital Infection |
Volume | 93 |
Issue number | 2 |
DOIs | |
Publication status | Published - Jun 2016 |
Keywords / Materials (for Non-textual outputs)
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Bacteremia
- Child
- Child, Preschool
- Cross Infection
- Epidemiological Monitoring
- Female
- Humans
- Infant
- Infant, Newborn
- Infection Control
- Male
- Middle Aged
- Prospective Studies
- Scotland
- Staphylococcal Infections
- Staphylococcus aureus
- Young Adult
- Journal Article