Epidemiology and outcomes of community-onset methicillin-susceptible Staphylococcus aureus bacteraemia in a university hospital in Singapore

BMC Infect Dis. 2008 Feb 7:8:14. doi: 10.1186/1471-2334-8-14.

Abstract

Background: Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia remains a condition associated with considerable morbidity and mortality worldwide. It is a common but little-studied problem outside of Europe and North America.

Methods: A single-centre retrospective case series profiling all patients with community onset-MSSA bacteraemia presenting between March 2005 and February 2006 to a tertiary acute-care university hospital in Singapore. In addition to epidemiological and clinical data collection, risk factors for complicated bacteremia and attributable mortality were analysed.

Results: A total of 100 patients met the case definition. Patients were more likely to be male (65%) and below 65 years of age (69%). Seventeen patients were intravenous drug abusers, while 38 had diabetes mellitus. There were 18 cases of endocarditis, with 11 occurring in intravenous buprenorphine abusers. Attributable mortality was 11%, and 46% of patients developed complicated bacteremia. On multivariate analysis, age > 65 years and presence of chronic pulmonary disease were the only significant risk factors for the former, while valvular heart disease was a significant risk factor for the latter.

Conclusion: MSSA bacteraemia is associated with a significant risk of serious complications in Singapore. Other Asian cities should be alert to the risk factors for adverse outcomes for this important cause of morbidity and mortality.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Analysis of Variance
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / diagnosis
  • Bacteremia / drug therapy*
  • Bacteremia / epidemiology*
  • Cohort Studies
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / epidemiology*
  • Community-Acquired Infections / microbiology
  • Female
  • Hospitals, University
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Methicillin / pharmacology*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Singapore / epidemiology
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification
  • Survival Analysis
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Methicillin