Temporal Trends in the Incidence of Staphylococcus aureus Bacteremia in Olmsted County, Minnesota, 1998 to 2005: A Population-Based Study
Temporal Trends in the Incidence of Staphylococcus aureus Bacteremia in Olmsted County, Minnesota, 1998 to 2005: A Population-Based Study
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DOI：
10.1086/648442
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发表时间：
2009-12-15
影响因子：
11.8
通讯作者：
Baddour, Larry M.
中科院分区：
文献类型：
--
作者：
El Atrouni, Wissam I.;Knoll, Bettina M.;Baddour, Larry M.
背景在美国，关于金黄色葡萄球菌菌血症（SAB）的人群研究很少。我们确定了明尼苏达州奥姆斯特德县SAB的发病率和趋势，超过8年的时间。本研究采用明尼苏达州罗切斯特的马约诊所和奥姆斯特德医学中心的微生物学数据库，对1998年1月1日至2005年12月31日明尼苏达州奥姆斯特德县成年居民中发生的SAB初始发作进行了回顾性、基于人群的队列研究。在纳入发生率计算的247例可评价的SAB成人患者中，143例（57.9%）为男性，中位年龄为72.1岁（范围：19.5-98.5岁）。根据获得类型对菌血症的流行进行分类：58例（23.5%）为医院获得性（N-SAB），145例（58.7%）为医疗保健相关性（HCA-SAB），44例（17.8%）为社区获得性（CA-SAB）。耐甲氧西林表皮葡萄金黄色葡萄球菌（MRSA）占31.6%。未发现社区获得性MRSA菌血症。年龄校正的SAB发病率为女性28.3次/100，000人-年，男性53.5次/100，000人-年，年龄和性别校正的发病率为38.2次/100，000人-年。NSAB、HCA-SAB和CA-SAB的年龄和性别校正发生率分别为9.0、22.6和6.6次发作/100，000人-年。经年龄和性别校正的甲氧西林敏感的S。金黄色葡萄球菌为25.4例/10万人年，MRSA为12.4例/10万人年。总的来说，发病率随年龄而增加，但不是在日历年内。MRSA菌血症是个例外，在研究期间以每年19.8%（标准误，+/-5.5%）的速度增加。从1998年到2005年，明尼苏达州奥姆斯特德县成人SAB的发病率保持稳定，但在8年期间，由于MRSA引起的发作比例显著增加。
Background. There is a paucity of population-based studies on Staphylococcus aureus bacteremia (SAB) in the United States. We determined the incidence of and trends in SAB in Olmsted County, Minnesota, over an 8-year period.Methods. A retrospective, population-based, cohort study was done to evaluate the initial episodes of SAB occurring in adult residents of Olmsted County, Minnesota, from 1 January 1998 through 31 December 2005, using the microbiology databases at Mayo Clinic and Olmsted Medical Center in Rochester, Minnesota.Results. Of 247 evaluable adult patients with SAB who were included in the incidence calculation, 143 (57.9%) were males, and the median age was 72.1 years (range, 19.5-98.5 years). Episodes of bacteremia were classified according to acquisition type: 58 (23.5%) were nosocomial (N-SAB), 145 (58.7%) were healthcare-associated (HCA-SAB), and 44 (17.8%) were community-acquired (CA-SAB). Methicillin-resistant S. aureus (MRSA) constituted 31.6% of the cases. No community-acquired MRSA bacteremia was noted. The age-adjusted incidence of SAB was 28.3 episodes/100,000 person-years for females and 53.5 episodes/100,000 person-years for males, with an age-and sex-adjusted rate of 38.2 episodes/100,000 person-years. The age-and sex-adjusted incidence of NSAB, HCA-SAB, and CA-SAB was 9.0, 22.6, and 6.6 episodes/100,000 person-years, respectively. The age-and sex-adjusted incidence of methicillin-susceptible S. aureus was 25.4 episodes/100,000 person-years, and that of MRSA was 12.4 episodes/100,000 person-years. Overall, the incidence rate increased with age but not over the calendar year. The exception was MRSA bacteremia, which increased at a rate of 19.8% (standard error, +/-5.5%) per year during the study.Conclusions. The incidence of SAB in adults remained stable in Olmsted County, Minnesota, from 1998 to 2005, but the proportion of episodes due to MRSA significantly increased over the 8-year period.