Staphylococcus aureus infections continue to be a cause of significant mortality and morbidity in spite of lower rates of methicillin-resistant S aureus, according to a study published in Morbidity and Mortality Weekly Report. Recommendations set forth by the Centers for Disease Control and Prevention (CDC) should be fully implemented in healthcare centers to further decrease procedural and device-related infections.

This study included data on S aureus bloodstream infections retrieved from the Premier and Cerner Electronic Health Record (2012-2017) and the Emerging Infections Program methicillin-resistant S aureus (2005-2016) databases. These 2 servers provided data on hospital- and community-onset methicillin-resistant and -susceptible S aureus bloodstream infections, which allowed the researchers to estimate the general US incidence and mortality during hospitalization. Poisson regression adjusted for population changes was used to model adjusted annual decreases, whereas generalized estimating equations binomial models were used to assess annual mortality differences.

Between 2005 and 2012 there was a 17.1% annual reduction in hospital-onset methicillin-resistant S aureus bloodstream infections. However, the rate of decline decreased between 2013 and 2016 (P =.25). Between 2005 and 2016 there was a 6.9% annual reduction in community-onset infections (P <.001). This reduction was largely explained by the associated reduction in rates of healthcare-associated community-onset bloodstream infections, which declined by 7.8% annually (P =.001). Conversely, hospital-onset methicillin-susceptible S aureus infection rates did not change significantly between 2012 and 2017 (P =.11), while community-onset bloodstream infections increased by 3.9% annually (P <.0001).

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The researchers concluded that “S aureus infections account for substantial morbidity in the United States. Despite significant reductions in healthcare-associated [methicillin-resistant S aureus] infections, progress is slowing. [Methicillin-susceptible S aureus] infections have not decreased as much in hospitals and might be increasing in the community. Adherence to CDC recommendations for preventing device- and procedure-associated infections and interrupting transmission, along with innovative interventions tailored to the needs of healthcare facilities (including decolonization), are needed to further prevent S aureus infections.”

Reference

Kourtis AP, Hatfield K, Baggs J, et al. Vital signs: epidemiology and recent trends in methicillin-resistant and in methicillin-susceptible _Staphylococcus aureus_bloodstream infections — United States. MMWR Morb Mortal Wkly Rep. 2019; 68:214-219.