Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008

BMC Infectious Diseases

Thomas Benfield⁴  Robert Skov¹  Anders R Larsen¹  Allan G Jensen³  Henrik C Schønheyder⁵  Henrik Westh²  Niels Mejer⁶ 

[1] Staphylococcal Laboratory, Statens Serum Institut, Copenhagen, Denmark;Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark;Pfizer, Ballerup, Denmark;Clinical Research Centre, Hvidovre University Hospital, Hvidovre, Denmark;Department of Clinical Microbiology, Aarhus University Hospital, Aalborg, Denmark;Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

关键词: Charlson comorbidity index;    Staphylococcus aureus;    Alcoholism;    Comorbidity;    Mortality;    Incidence;    Epidemiology;    Bacteraemia;   

Others  :  1159631
DOI  :  10.1186/1471-2334-12-260

 received in 2012-03-04, accepted in 2012-10-11,  发布年份 2012

【 摘 要 】

Background

The objective of this study was to assess temporal changes in incidence and short term mortality of Staphylococcus aureus bacteraemia (SAB) from 1995 through 2008.

Methods

The study was conducted as a nation-wide observational cohort study with matched population controls. The setting was hospitalized patients in Denmark 1995-2008. Uni- and multivariate analyses were used to analyze the hazard of death within 30 days from SAB.

Results

A total of 16 330 cases of SAB were identified: 57% were hospital-associated (HA), 31% were community-acquired (CA) and 13% were of undetermined acquisition. The overall adjusted incidence rate remained stable at 23 per 100 000 population but the proportion of SAB cases older than 75 years increased significantly. Comorbidity in the cohort as measured by Charlson comorbidity index (CCI) score and alcohol-related diagnoses increased over the study period. In contrast, among the population controls the CCI remained stable and alcohol-related diagnoses increased slightly. For HA SAB crude 30-day mortality decreased from 27.8% to 21.8% (22% reduction) whereas the change for CA SAB was small (26.5% to 25.8%). By multivariate Cox regression, age, female sex, time period, CCI score and alcohol-related diagnoses were associated with increased mortality regardless of mode of acquisition.

Conclusions

Throughout a 14-year period the overall incidence of SAB remained stable while the overall short term prognosis continued to improve despite increased age and accumulation of comorbidity in the cohort. However, age and comorbidity were strong prognostic indicators for short term mortality.

【 授权许可】

   
2012 Mejer et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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