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Erschienen in: Infection 1/2017

13.07.2016 | Original Paper

Time trends in Staphylococcus aureus bacteremia, 1988–2010, in a tertiary center with high methicillin resistance rates

verfasst von: Dafna Yahav, Hila Shaked, Elad Goldberg, Sharief Yassin, Noa Eliakim-Raz, Mical Paul, Jihad Bishara, Leonard Leibovici

Erschienen in: Infection | Ausgabe 1/2017

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Abstract

Introduction

Changes in the epidemiology of Staphylococcus aureus bacteremia (SAB) have been described in recent decades. Decreased mortality has been reported over time, mostly from countries with low methicillin resistance rates. We aimed to describe time trends in SAB in a tertiary center with high methicillin resistance rates.

Methods

We retrospectively analyzed 1692 patients with SAB, and compared between three time periods: 1988–1994 (342 patients), 1998–2004 (597 patients) and 2005–2010 (753 patients).

Results

In our cohort, 30 days mortality increased significantly with time, reaching 42.9 % during 2005–2010. The latter period was characterized by higher rates of older patients (35.1 % aged 80 years and older), with lower functional capacity (46.5 % bedridden) and higher rates of comorbidities (33.6 % renal disease, 24.8 % heart failure, 19.0 % dementia). These patients were more likely to be ventilated (18.7 %) and carry a urinary catheter at presentation (46.6 %); present with septic shock (15.9 %) and have pneumonia (20.5 %) or endocarditis (7.2 %) as source. Similar characteristics were found among patients younger than 50 years and with independent functional status. No significant increase in methicillin resistant Staph aureus (MRSA) rates or inappropriate empirical therapy was demonstrated during 2005–2010.

Conclusions

In our cohort, increased mortality in recent years in patients with SAB can be explained by baseline condition of patients. MRSA or inappropriate empiric therapy did not explain the increase in mortality. The patients afflicted with SAB changed over time. Epidemiology and outcomes of SAB vary with time and according to geographical location. External validity of studies should be taken into consideration.
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Metadaten
Titel
Time trends in Staphylococcus aureus bacteremia, 1988–2010, in a tertiary center with high methicillin resistance rates
verfasst von
Dafna Yahav
Hila Shaked
Elad Goldberg
Sharief Yassin
Noa Eliakim-Raz
Mical Paul
Jihad Bishara
Leonard Leibovici
Publikationsdatum
13.07.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 1/2017
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-016-0919-6

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