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Multicenter Study
. 2006 Aug 5;333(7562):281.
doi: 10.1136/bmj.38834.421713.2F. Epub 2006 Jun 23.

Mortality after Staphylococcus aureus bacteraemia in two hospitals in Oxfordshire, 1997-2003: cohort study

David H Wyllie  1 , Derrick W Crook, Tim E A Peto
Affiliations
Multicenter Study

Mortality after Staphylococcus aureus bacteraemia in two hospitals in Oxfordshire, 1997-2003: cohort study

David H Wyllie et al. BMJ. .

Erratum in

  • BMJ. 2006 Sep 2;333(7566):468

Abstract

Objective: To determine the incidence of methicillin resistant and methicillin sensitive Staphylococcus aureus (MRSA and MSSA) bacteraemia in inpatients and associated mortality within 30 days after diagnosis.

Design: Anonymised record linkage study of data from hospital information systems and microbiology databases.

Setting: Teaching hospital and district general hospital in Oxfordshire.

Participants: Inpatients aged 18 or over admitted to a teaching hospital between 1 April 1997 and 31 March 2004 and to a district general hospital between 1 April 1999 and 31 March 2004. The main part of the study comprised 216 644 inpatients; patients admitted to haematology, nephrology, or oncology services were not included because most were managed as outpatients.

Outcome measures: Nosocomial MSSA and MRSA bacteraemia; death in hospital within 30 days after bacteraemia.

Results: Rates of S aureus bacteraemia rose between 1997 and 2003, and MRSA was responsible for this increase. Overall mortality 30 days after bacteraemia was 29%. The crude odds ratio for death after MRSA bacteraemia compared with MSSA bacteraemia was 1.49 (95% confidence interval 0.99 to 2.26).

Conclusion: The spread of MRSA has greatly increased the overall number of cases of S aureus bacteraemia and has contributed to short term mortality after S aureus bacteraemia.

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Figures

Fig 1
Fig 1
Admissions and cases of bacteraemia in two Oxfordshire hospitals, 1997-2003
Fig 2
Fig 2
Changes in rates of nosocomial bacteraemia over time in two Oxfordshire hospitals (n=144 134). Regression lines indicate change over time. Asterisks indicate that the slope of the line is significant (P<0.01; P>0.20 for the others)
Fig 3
Fig 3
Changes in previous isolation of methicillin resistant Staphyloccocus aureus (MRSA), age, and duration of stay over time in two Oxfordshire hospitals (n=144 134). Regression lines indicate change over time. Asterisks indicate that the slope of the line is significant (P<0.01; P>0.20 for the others)
Fig 4
Fig 4
Rates of nosocomial bacteraemia according to previous isolation of methicillin resistant Staphyloccocus aureus (MRSA) in two Oxfordshire hospitals (n=144 134). P<0.01
Fig 5
Fig 5
Rates of nosocomial bacteraemia according to duration of stay (top) and age (bottom) in two Oxfordshire hospitals (n=144 134), log scale. Asterisks indicate that the slope of the regression line is significant (P<0.01; P>0.20 for the others)
Fig 6
Fig 6
Risk of death for inpatients in two Oxfordshire hospitals (n=144 134) according to age and year
Fig 7
Fig 7
Risk of death 30 days after diagnosis of Staphylococcus aureus bacteraemia in two Oxfordshire hospitals (n=144 134)
See this image and copyright information in PMC

Comment in

References

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