Abstract
BackgroundMethicillin-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.MethodsA 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.ResultsA 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.ConclusionMSSA 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.
Highlights
Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia remains a condition associated with considerable morbidity and mortality worldwide
This study describes the epidemiology of COMSSA bacteraemia and the risk factors for mortality and complicated infections in patients seen at a university hospital in Singapore, a modern Asian city
A patient was defined as having community-onset MSSA (CO-MSSA) bacteraemia if MSSA-positive blood cultures had been drawn < 48 hours after hospitalisation or if he/she remained symptomatic with no other cause of infection found in the event that blood cultures were positive > 48 hours post-hospitalisation
Summary
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. Staphylococcus aureus bacteraemia remains a common cause of mortality and morbidity both in spite of and as a consequence of medical advances. CA-MRSA is still relatively rare on a global basis, whereas MSSA is a more common cause of bacteraemia than MRSA in most parts of the world. The incidence of MSSA bacteraemias is not significantly affected by the slew of infection control measures set in place in most health care institutions
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