Epidemiology and Outcome Determinants of Staphylococcus aureus Bacteremia Revisited: A Population-Based Study
- 203 Downloads
Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality. We sought to re-define the burden, epidemiology and mortality-associated risk factors of SAB in a large Canadian health region.
Residents (> 18 years) experiencing SAB from 2012 to 2014 were assessed. Incidence rates were calculated using civic census results. Factors associated with 30-day mortality were determined through multivariate logistic regression. Incidence and risk factors for SAB were compared to 2000–2006 data.
780 residents experienced 840 episodes of SAB (MRSA; 20%). Incidence rates increased from 23.5 to 32.0 cases/100,000 from 2012 to 2014; [IRR 1.15 (95% CI 1.07–1.23); p < 0.001]. Compared to a decade ago, incidence of SAB has increased [IRR 1.28 (95% CI 1.21–1.36); p < 0.001] despite minimal change in nosocomial SAB. MRSA proportion did not change through the study (p = 0.3), but did increase relative to a decade ago (20.0% vs 11.0%, p < 0.001). Thirty-day mortality rates were 30.6% and 21.3% for MRSA and MSSA, respectively (p = 0.01), similar to rates from 2000 to 2006. Several clinical, demographic, and biochemical factors were independently associated with SAB mortality.
SAB is common within our population resulting in significant mortality. Incidence rates of SAB are increasing in our health region; however, 30-day mortality rates remain stable.
KeywordsBacteremia Staphylococcus aureus MRSA Mortality Epidemiology
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors
Compliance with ethical standards
Conflict of interest
All authors declare that they do not have any conflict of interest relevant to this manuscript.
Presented in part
Association of Medical Microbiology and Infectious Disease Conference 2018, Vancouver, BC. Abstract SP 44.
- 2.Public Health England: Staphylococcus aureus (MRSA and MSSA) bacteraemia mandatory reports 2016/17. United Kingdom.Google Scholar
- 9.Alberta Health Services Annual Report 2015-2016: Alberta Health Services.Google Scholar
- 10.The City of Calgary—Past census results. Available at: http://www.calgary.ca/CA/city-clerks/Pages/Election-and-Information-Services/Civic-Census/CensusResults.aspx. Accessed October 11 2018.
- 11.Performance Standards for Antimicrobial Susceptibility Testing. Supplement M100. Wayne: Clincal and Laboratory Standards Institute; 2017.Google Scholar
- 17.Stokes W, Parkins MD, Parfitt ECT, Ruiz JC, Mugford G, Gregson DB. Incidence and outcomes of Staphylococcus aureus bacteriuria: a population-based study. Clin Infect Dis. 2018;3:1.Google Scholar
- 18.The City of Calgary—Past census results. Available at: http://www.calgary.ca/CA/city-clerks/Pages/Election-and-Information-Services/Civic-Census/CensusResults.aspx. Accessed October 11, 2018 2018.
- 19.Services AH. Available at: https://www.albertahealthservices.ca/about/calgaryzone.aspx. Accessed December 20 2018.
- 30.Lam J, Robinson S, Gregson D, et al. Staphylococcus aureus bacteremia (SAB) management in a large metropolitan integrated health region: quality of care determinants (QoCD). In: ID Week. (San Diego, California). Open Forum Infectious Diseases pp S557–S8.Google Scholar
- 32.Lam JC, Gregson DB, Robinson S, et al. Infectious diseases consultation improves key performance metrics in the management of Staphylococcus aureus bacteremia: a multicentre cohort study. J Assoc Med Microbiol Infect Dis Canada. 2019;4:24–32.Google Scholar