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 ORCID: 0000-0002-4713-9662, 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: 13 Feb 2018 15:15
URI: http://repository.uwl.ac.uk/id/eprint/936

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