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Evolving Epidemiology of Staphylococcus aureus Bacteremia

Published online by Cambridge University Press:  16 September 2015

Yoona Rhee ,
Alla Aroutcheva ,
Bala Hota ,
Robert A. Weinstein  and
Kyle J. Popovich
Yoona Rhee
Affiliation:
Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois Division of Infectious Diseases, Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
Alla Aroutcheva
Affiliation:
Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois Division of Infectious Diseases, Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
Bala Hota
Affiliation:
Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois Division of Infectious Diseases, Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
Robert A. Weinstein
Affiliation:
Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois Division of Infectious Diseases, Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
Kyle J. Popovich*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois Division of Infectious Diseases, Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
*
Address correspondence to Kyle J. Popovich, MD, MS, Rush University Medical Center, Division of Infectious Diseases, 600 S Paulina St, Ste 143, Chicago, IL 60612 (kyle_popovich@rush.edu).
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Abstract

BACKGROUND

Methicillin-resistant Staphylococcus aureus (MRSA) infections due to USA300 have become widespread in community and healthcare settings. It is unclear whether risk factors for bloodstream infections (BSIs) differ by strain type.

OBJECTIVE

To examine the epidemiology of S. aureus BSIs, including USA300 and non-USA300 MRSA strains.

DESIGN

Retrospective observational study with molecular analysis.

SETTING

Large urban public hospital.

PATIENTS

Individuals with S. aureus BSIs from January 1, 2007 through December 31, 2013.

METHODS

We used electronic surveillance data to identify cases of S. aureus BSI. Available MRSA isolates were analyzed by pulsed-field gel electrophoresis. Poisson regression was used to evaluate changes in BSI incidence over time. Risk factor data were collected by medical chart review and logistic regression was used for multivariate analysis of risk factors.

RESULTS

A total of 1,015 cases of S. aureus BSIs were identified during the study period; 36% were due to MRSA. The incidence of hospital-onset (HO) MRSA BSIs decreased while that of community-onset (CO) MRSA BSIs remained stable. The rate of CO– and HO– methicillin-susceptible S. aureus infections both decreased over time. More than half of HO-MRSA BSIs were due to the USA300 strain type and for 4 years, the proportion of HO-MRSA BSIs due to USA300 exceeded 60%. On multivariate analysis, current or former drug use was the only epidemiologic risk factor for CO- or HO-MRSA BSIs due to USA300 strains.

CONCLUSIONS

USA300 MRSA is endemic in communities and hospitals and certain populations (eg, those who use illicit drugs) may benefit from enhanced prevention efforts in the community.

Infect. Control Hosp. Epidemiol. 2015;36(12):1417–1422

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 12 , December 2015 , pp. 1417 - 1422
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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