Staphylococcus aureus bacteraemia in Iceland, 1995-2008: changing incidence and mortality
Staphylococcus aureus bacteraemia in Iceland, 1995-2008: changing incidence and mortality
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DOI：
10.1111/j.1469-0691.2010.03265.x
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发表时间：
2011-04-01
影响因子：
14.2
通讯作者：
Kristjansson, M.
中科院分区：
文献类型：
--
作者：
Asgeirsson, H.;Gudlaugsson, O.;Kristjansson, M.
关于金黄色葡萄球菌菌血症流行病学的时间变化知之甚少。本研究的目的是分析成年S。冰岛的金黄色葡萄球菌菌血症。18岁或18岁以上血培养阳性的人。1995年1月1日至2008年12月31日期间，在冰岛进行血培养的所有临床微生物实验室的参与下，确定了1995年1月1日至2008年12月31日期间的金黄色葡萄球菌。感染分为医院感染、医疗相关感染或社区获得性感染。全国人口统计数据和死亡日期从国家登记处检索。在研究期间，来自19个机构的692名个人有721次不同的S。金黄色菌血症在此期间，发病率从22.7/100 000/年上升至28.9/100 000/年（p 0.012）。医院感染占病例的46.3%，14.6%与医疗保健相关，39.1%为社区获得性。在此期间，医院感染的比例下降（p <0.001），而社区获得性感染的比例增加（p <0.001）。1995 - 1996年和2007 - 2008年期间，全因30天死亡率从25.0%降至8.1%（p 0.001），1年死亡率从37.0%降至27.9%（p 0.061）。报告4例耐甲氧西林链球菌菌血症。金黄色葡萄球菌（0.6%），无致死性。总之，S. 1995年至2008年冰岛的金黄色葡萄球菌菌血症。与此同时，死亡率大幅下降，接近报告的最低水平。需要进一步的研究来了解这些变化的基础。
P>Little is known about temporal changes in the epidemiology of Staphylococcus aureus bacteraemia. The objective of the present study was to analyse changes in the incidence and mortality of adult S. aureus bacteraemia in Iceland. Individuals 18 years or older with a positive blood culture for S. aureus between 1 January 1995 and 31 December 2008 were identified, with the participation of all clinical microbiological laboratories performing blood cultures in Iceland. Infections were categorized as nosocomial, healthcare-associated or community-acquired. National population statistics and dates of death were retrieved from the National Registry. During the study period, 692 individuals from 19 institutions had 721 distinct episodes of S. aureus bacteraemia. The incidence rose from 22.7 to 28.9 per 100 000 per year during the period (p 0.012). Nosocomial infections comprised 46.3% of cases, 14.6% were healthcare-associated, and 39.1% were community-acquired. The proportion of nosocomial infections decreased during the period (p < 0.001), whereas an increase was seen in the proportion of community-acquired infections (p < 0.001). All-cause 30-day mortality decreased from 25.0% to 8.1% (p 0.001) and 1-year mortality decreased from 37.0% to 27.9% (p 0.061) between the periods 1995-1996 and 2007-2008. Four cases of bacteraemia caused by methicillin-resistant S. aureus were seen (0.6%), none of which was fatal. In conclusion, there was a significant increase in the incidence of S. aureus bacteraemia in Iceland between 1995 and 2008. Concomitantly, there was a significant reduction in mortality, towards one of the lowest reported. Further studies are needed to understand the basis for these changes.