Program Schedule

285
Secular Trends in Staphylococcus aureus Bloodstream Infections over Four Decades

Session: Poster Abstract Session: MRSA and VRE
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • S aureus 2014 Final.pdf (587.0 kB)
  • Background:

    The epidemiology of bloodstream infections due to Staphylococcus aureus (SA-BSI) has changed dramatically over the last several decades with the widespread use of intravascular catheters, the emergence and spread of methicillin resistant S. aureus (MRSA) and the rise of community-onset infections. We examined secular trends in SA-BSI occurring from 1980 to 2013 with particular focus on MRSA, source of BSI and location of onset.

    Methods:

    Records were reviewed for all patients with SA-BSI who were hospitalized at one academic medical center.  Rates of SA-BSI per 1,000 discharged patients were calculated for the first four years of four decades (1980-1983, 1990-1993, 2000-2003 and 2010-2013).  Temporal trends were assessed for proportion of SA-BSI due to MRSA and attributed source.

    Results:

    Rates of SA-BSI increased from the 1980-3 study period through the 2000-3 study period however both hospital-onset and community-onset BSIs decreased in the last study period (Figure). In the 1980-3 study period there was only one central line-associated BSI (CLABSI) and two MRSA BSIs.  The increase in SA-BSI through 2000-3 was driven by an increase in CLABSI for both hospital-onset and community-onset BSIs; in the 2000-3 period, 75/235 hospital-onset and 166/400 community-onset SA-BSIs (127 of which were dialysis catheter related) were CLABSIs. Hospital-onset SA-BSI decreased by 48% in the 2010-13 period with 51/123 SA-BSI being CLABSIs. Since 2000-3, MRSA has accounted for about half of all SA-BSI although there was a decrease in the proportion of hospital-onset SA-BSI caused by MRSA over the last two study periods, from 57.0% in 2000-3 to 41.5% in 2010-13.

    Conclusion:

    There was an increase in SA-BSI in the first three decades of the study period, in large part due to CLABSIs in and outside the hospital.  In the last decade there has been a decrease in SA-BSI, with a marked decrease in hospital-onset infections, including a decrease in CLABSI.  While MRSA still causes almost half of all SA-BSI, there was a notable decrease in hospital-onset MRSA in recent years.

    Chad Robichaux, MPH1, Kristin Hake, RN, MPH2, Susan Cali, MSN, RN, MHA1, Jesse Jacob, MD3 and James Steinberg, MD3, (1)Office of Quality, Emory Healthcare, Atlanta, GA, (2)Infection Control and Prevention, Emory Healthcare, Atlanta, GA, (3)Emory University School of Medicine, Atlanta, GA

    Disclosures:

    C. Robichaux, None

    K. Hake, None

    S. Cali, None

    J. Jacob, None

    J. Steinberg, None

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