Enhanced surveillance of Staphylococcus aureus bacteraemia to identify targets for infection prevention. Issue 2 (June 2016)

• Record Type: Journal Article
• Authors: Morris, A.K.; Russell, C.D.
• Is Part Of: Journal of hospital infection. Volume 93:Issue 2(2016)
• Page Start: 169
• Page End: 174
• Publication Date: 2016-06
• Subjects: Staphyloccocus aureus -- Bacteraemia -- Surveillance -- Epidemiology -- Outcome; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2016.03.003
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: 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.