Trends in sources of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia: data from the national mandatory surveillance of MRSA bacteraemia in England, 2006–2009

Wilson, Jennie, Guy, Rebecca, Elgohari, Suzanne, Sheridan, Elizabeth, Davies, J., Lamagni, Theresa and Pearson, A. (2011) Trends in sources of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia: data from the national mandatory surveillance of MRSA bacteraemia in England, 2006–2009. Journal of Hospital Infection, 79 (3). pp. 211-217. ISSN 0195-6701

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Abstract

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.

Item Type: Article
Uncontrolled Keywords: Healthcare associated; Intravascular devices; MRSA bacteraemia; Skin and soft tissue infection
Subjects: Medicine and health > Microbiology
Depositing User: Rod Pow
Date Deposited: 12 Sep 2014 13:33
Last Modified: 10 Nov 2017 16:33
URI: http://repository.uwl.ac.uk/id/eprint/936

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