Increasing incidence but decreasing in-hospital mortality of adult Staphylococcus aureus bacteraemia between 1981 and 2000
Increasing incidence but decreasing in-hospital mortality of adult Staphylococcus aureus bacteraemia between 1981 and 2000
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DOI：
10.1111/j.1469-0691.2006.01589.x
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发表时间：
2007-03-01
影响因子：
14.2
通讯作者：
Skinhoj, P.
中科院分区：
文献类型：
--
作者：
Benfield, T.;Espersen, F.;Skinhoj, P.
金黄色葡萄球菌是菌血症的主要原因。本研究分析了 1981 年至 2000 年间丹麦 18 702 例金黄色葡萄球菌菌血症成人病例的时间趋势。根据获得方式分层后，57% 的病例为医院获得性 (HA)，28% 为社区获得性 (CA)，15% 为未确定获得性 (UA)。发病率从 18.2 例/10 万人增加到 30.5 例/10 万人。 CA、HA 和 UA 病例的年增长率分别为 6.4%、2.2% 和 3.6%。与HA菌血症相关的病例死亡率从36.2%下降至20.7%（比率降低43%，p = 0.0001），而CA菌血症则从34.5%下降至26.5%（比率降低23%，p = 0.0001）。经过多变量分析，无论感染方式如何，年龄、肺炎、心内膜炎和慢性病都与死亡率增加相关。总体而言，1981年至2000年间，与金黄色葡萄球菌菌血症相关的死亡率显着下降，但发病率却翻了一番，因此死亡总数有所增加。这些数据强调了金黄色葡萄球菌菌血症对公共卫生的重要性，以及需要采取进一步的预防措施和改善护理，以降低发病率并改善结果。
Staphylococcus aureus is a leading cause of bacteraemia. This study analysed temporal trends from 18 702 adult cases of S. aureus bacteraemia in Denmark between 1981 and 2000. After stratification for mode of acquisition, 57% of cases were hospital-acquired (HA), 28% were community-acquired (CA) and 15% were of undetermined acquisition (UA). Incidence rates increased from 18.2 to 30.5 cases/100 000 population. Annual rates increased by 6.4% for CA, by 2.2% for HA and by 3.6% for UA cases, respectively. Case-mortality associated with HA bacteraemia decreased from 36.2% to 20.7% (43% rate reduction, p 0.0001), compared with a decrease from 34.5% to 26.5% (23% rate reduction, p 0.0001) for CA bacteraemia. Following multivariate analysis, age, pneumonia, endocarditis and chronic illness were associated with increased mortality, regardless of the mode of acquisition. Overall, mortality associated with S. aureus bacteraemia declined significantly between 1981 and 2000, but incidence rates doubled, so that the total number of deaths increased. These data emphasise the public health importance of S. aureus bacteraemia and the need for further preventive measures and improved care in order to reduce incidence rates and improve outcomes.