TY - JOUR
T1 - Trends in sources of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia
T2 - Data from the national mandatory surveillance of MRSA bacteraemia in England, 2006-2009
AU - Wilson, J.
AU - Guy, R.
AU - Elgohari, S.
AU - Sheridan, E.
AU - Davies, J.
AU - Lamagni, Theresa
AU - Pearson, A.
PY - 2011/11
Y1 - 2011/11
N2 - The national mandatory surveillance system for reporting meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia in England has captured data on the source of reported bacteraemias since 2006. This study analysed episodes of MRSA bacteraemia (N= 4404) where a probable source of infection was reported between 2006 and 2009. In 2009, this information was available for one-third of reported episodes of MRSA bacteraemia. Of these, 20% were attributed to intravascular devices and 28% were attributed to skin and soft tissue infection. Sixty-four percent of the patients were male, and urinary tract infection was a significantly more common source of MRSA bacteraemia in males compared with females (12% vs 3%). Detection of bacteraemia within two days of hospital admission does not reliably discriminate between community- and hospital-associated MRSA bacteraemia as community cases are frequently associated with an invasive procedure/device. Between 2006 and 2009, there was a significant decline in the proportion of episodes of MRSA bacteraemia associated with central vascular catheters [incidence rate ratio (IRR) 0.42, 95% confidence interval (CI) 0.29-0.61; P< 0.001], peripheral vascular catheters (IRR 0.69, 95% CI 0.48-0.99; P= 0.042) and surgical site infection (IRR 0.42, 95% CI 0.25-0.72; P= 0.001), and a significant increase in the proportion of episodes of MRSA bacteraemia associated with skin and soft tissue infection (IRR 1.33, 95% CI 1.05-1.69; P= 0.017) and attributed to contamination of the specimen (IRR 1.96, 95% CI 1.25-3.06; P= 0.003). Since data were not available for all cases, the generalizability of these trends depends on the assumption that records with source data reflect a reasonably random sample of cases in each year. These changes have occurred in the context of a general decline in the rate of MRSA bacteraemia in England since 2006.
AB - The national mandatory surveillance system for reporting meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia in England has captured data on the source of reported bacteraemias since 2006. This study analysed episodes of MRSA bacteraemia (N= 4404) where a probable source of infection was reported between 2006 and 2009. In 2009, this information was available for one-third of reported episodes of MRSA bacteraemia. Of these, 20% were attributed to intravascular devices and 28% were attributed to skin and soft tissue infection. Sixty-four percent of the patients were male, and urinary tract infection was a significantly more common source of MRSA bacteraemia in males compared with females (12% vs 3%). Detection of bacteraemia within two days of hospital admission does not reliably discriminate between community- and hospital-associated MRSA bacteraemia as community cases are frequently associated with an invasive procedure/device. Between 2006 and 2009, there was a significant decline in the proportion of episodes of MRSA bacteraemia associated with central vascular catheters [incidence rate ratio (IRR) 0.42, 95% confidence interval (CI) 0.29-0.61; P< 0.001], peripheral vascular catheters (IRR 0.69, 95% CI 0.48-0.99; P= 0.042) and surgical site infection (IRR 0.42, 95% CI 0.25-0.72; P= 0.001), and a significant increase in the proportion of episodes of MRSA bacteraemia associated with skin and soft tissue infection (IRR 1.33, 95% CI 1.05-1.69; P= 0.017) and attributed to contamination of the specimen (IRR 1.96, 95% CI 1.25-3.06; P= 0.003). Since data were not available for all cases, the generalizability of these trends depends on the assumption that records with source data reflect a reasonably random sample of cases in each year. These changes have occurred in the context of a general decline in the rate of MRSA bacteraemia in England since 2006.
KW - Healthcare associated
KW - Intravascular devices
KW - MRSA bacteraemia
KW - Skin and soft tissue infection
UR - http://www.scopus.com/inward/record.url?scp=80053323878&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2011.05.013
DO - 10.1016/j.jhin.2011.05.013
M3 - Article
C2 - 21764174
AN - SCOPUS:80053323878
SN - 0195-6701
VL - 79
SP - 211
EP - 217
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
IS - 3
ER -
