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Trends and outcome of nosocomial and community-acquired bloodstream infections due to Staphylococcus aureus in Finland, 1995–2001

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Abstract

In Finland, Staphylococcus aureus bloodstream infections are caused predominantly (>99%) by methicillin-sensitive strains. In this study, laboratory-based surveillance data on Staphylococcus aureus bloodstream infections occurring in Finland from 1995 to 2001 were analyzed. Preceding hospitalizations for all persons with Staphylococcus aureus bloodstream infections were obtained from the national hospital discharge registry, and data on outcome was obtained from the national population registry. An infection was defined as nosocomial when a positive blood culture was obtained more than 2 days after hospital admission or within 2 days of admission if there was a preceding hospital discharge within 7 days. A total of 5,045 cases were identified. The annual incidence of Staphylococcus aureus bloodstream infection rose by 55%, from 11 per 100,000 population in 1995 to 17 in 2001. The increase was detected in all adult age groups, though it was most distinct in patients >74 years of age. Nosocomial infections accounted for 51% of cases, a proportion that remained unchanged. The 28-day death-to-case ratio ranged from 1% in the age group 1–14 years to 33% in patients >74 years of age. The 28-day death-to-case ratios for nosocomial and community-acquired infections were 22% and 13%, respectively, and did not change over time. The increase in incidence among elderly persons resulted in an increase in the annual rate of mortality associated with Staphylococcus aureus bloodstream infections, from 2.6 to 4.2 deaths per 100,000 population per year. Staphylococcus aureus bloodstream infections are increasing in Finland, a country with a very low prevalence of methicillin resistance. While the increase may be due in part to increased reporting, it also reflects a growing population at risk, affected by such factors as high age and/or severe comorbidity.

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References

  1. Banerjee SN, Emori TG, Culver DH, et al (1991) Secular trends in nosocomial primary bloodstream infections in the United States, 1980–1989. Am J Med 91 (Suppl 3B):86–89

    Article  Google Scholar 

  2. Weinstein MP, Towns ML, Quartey SM, et al (1997) The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin Infect Dis 24:584–602

    Google Scholar 

  3. Reacher MH, Shah A, Livermore DM, et al (2000) Bacteremia and antibiotic resistance of its pathogens reported in England and Wales between 1990 and 1998: trend analysis. BMJ 320:213–216

    Article  CAS  PubMed  Google Scholar 

  4. McBean M, Rajamani S (2001) Increasing rates of hospitalization due to septicemia in the U.S. elderly population, 1986–1997. J Infect Dis 183:596–603

    Article  CAS  PubMed  Google Scholar 

  5. Steinberg JP, Clark CC, Hackman BO (1996) Nosocomial and community-acquired Staphylococcus aureus bacteremias from 1980 to 1993: impact of vascular devices and methicillin resistance. Clin Infect Dis 23:255–259

    CAS  PubMed  Google Scholar 

  6. McClelland RS, Fowler VG, Sanders LL, et al (1999) Staphylococcus aureus bacteremia among elderly vs. younger adult patients. Arch Intern Med 159:1244–1247

    Article  CAS  PubMed  Google Scholar 

  7. Mylotte JM, Tayara A (2000) Staphylococcus aureus bacteremia: predictors of 30-day mortality in a large cohort. Clin Infect Dis 31:1170–1174

    Article  CAS  PubMed  Google Scholar 

  8. Jensen AG, Wachmann CH, Poulsen KB, et al (1999) Risk factors for hospital-acquired Staphylococcus aureus bacteremia. Arch Intern Med 159:1437–1444

    Article  CAS  PubMed  Google Scholar 

  9. Jensen AG, Wachmann CH, Poulsen KB, et al (2002) Treatment and outcome of Staphylococcus aureus bacteremia: prospective study of 278 cases. Arch Intern Med 162:25–32

    Article  CAS  PubMed  Google Scholar 

  10. Fätkenheuer G, Preuss M, Salzberger B, et al (2004) Long-term outcome and quality of care of patients with Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis 23:157–162

    Google Scholar 

  11. Espesen F, Rosdahl VT, Frimodt-Moller N, Skinhoj P (1994) Epidemiology of Staphylococcus aureus bacteremia in Denmark. J Chemother 6:219–225

    PubMed  Google Scholar 

  12. Frimodt-Moller N, Espersen F, Skinhoj P, Rosdahl VT (1997) Epidemiology of Staphylococcus aureus bacteremia in Denmark from 1957 to 1990. Clin Microbiol Infect 3:297–305

    PubMed  Google Scholar 

  13. Morin CA, Hadler JL (2001) Population-based incidence and characteristics of community-onset Staphylococcus aureus infections with bacteremia in 4 metropolitan Connecticut areas, 1998. J Infect Dis 184:1024–1034

    Article  Google Scholar 

  14. Laupland KB, Church DL, Mucenski M, Sutherland LR, Davies DH (2003) Population-based study of the epidemiology of and the risk factors for invasive Staphylococcus aureus infections. J Infect Dis 187:1452–1459

    Article  PubMed  Google Scholar 

  15. Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y (2003) Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 36:53–59

    Article  PubMed  Google Scholar 

  16. Morgan M, Salmon R, Keppie N, Evans-Williams D, Hosein I, Looker DN (1999) All Wales surveillance of methicillin-resistant Staphylococcus aureus (MRSA): the first year’s results. J Hosp Infect 41:173–179

    Article  CAS  PubMed  Google Scholar 

  17. McDonald P, Mitchell E, Johnson H, et al (2002) MRSA bacteremia: north/south study of MRSA in Ireland 1999. J Hosp Infect 52:288–291

    Article  CAS  PubMed  Google Scholar 

  18. Griffiths C, Lamagni TL, Crowcroft NS, Duckworth G, Rooney C (2004) Trends in MRSA in England and Wales: analysis of morbidity and mortality data for 1993–2002. Health Stat Q 21:15–22

    PubMed  Google Scholar 

  19. European Antimicrobial Resistance Surveillance System (2002) EARSS annual report 2001. http://www.earss.rivm.nl. Cited 7 Dec 2004

  20. Pfaller MA, Jones RN, Doern GV, Sader HS, Kugler KC, Beach ML, and the SENTRY Participants Group (1999) Survey of blood stream infections attributable to gram-positive cocci: frequency of occurrence and antimicrobial susceptibility of isolates collected in 1997 in the United States, Canada, and Latin America from the SENTRY Antimicrobial Surveillance Program. Diagn Microbiol Infect Dis 33:283–297

    Article  CAS  PubMed  Google Scholar 

  21. Diekeman DJ, Pfaller MA, Jones RN, et al (2000) Trends in antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections in the USA, Canada and Latin America. Int J Antimicrob Agents 13:257–271

    Article  PubMed  Google Scholar 

  22. Fluit AC, Jones ME, Schmitz FJ, Acar J, Gupta R, Verhoef J, and the SENTRY Participants Group (2000) Antimicrobial susceptibility and frequency of occurrence of clinical blood isolates in Europe from the SENTRY Antimicrobial Surveillance Program, 1997 and 1998. Clin Infect Dis 30:454–460

    Article  CAS  PubMed  Google Scholar 

  23. Infectious diseases in Finland 2001 (2002) Publications of the National Public Health Institute. KTL B9/2002. http://www.ktl.fi. Cited 7 Dec 2004

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Acknowledgments

We thank Jukka Ollgren and Teemu Möttönen for technical assistance in data management and statistical analyses, and the staff of the Finnish clinical microbiology laboratories for contributing to the collection of national identity codes for persons with SABSI

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Correspondence to O. Lyytikäinen.

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Lyytikäinen, O., Ruotsalainen, E., Järvinen, A. et al. Trends and outcome of nosocomial and community-acquired bloodstream infections due to Staphylococcus aureus in Finland, 1995–2001. Eur J Clin Microbiol Infect Dis 24, 399–404 (2005). https://doi.org/10.1007/s10096-005-1345-3

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