title: Nosocomial and community-acquired Staphylococcus aureus bacteremias from 1980 to 1993: impact of intravascular devices and methicillin resistance.
abstract: The rate of nosocomial bacteremia due to Staphylococcus aureus has increased over the past decade, but trends in community-acquired S. aureus bacteremia are less certain. This hospital-based observational study compares nosocomial and community-acquired S. aureus bacteremias during 1980-1983 and 1990-1993. The rate of nosocomial S. aureus bacteremia increased from 0.75 to 2.80 cases per 1,000 discharges, while the rate of community-acquired S. aureus bacteremia increased from 0.84 to 2.43 cases per 1,000 discharges. The number of nosocomial device-related bacteremias increased eightfold; 56% of S. aureus bacteremias were associated with devices during 1990-1993. Intravascular devices were associated with no community-acquired S. aureus bacteremias during 1980-1983 but with 22% during 1990-1993. Methicillin-resistant S. aureus (MRSA) seldom caused bacteremia during 1980-1983. From 1990 to 1993, MRSA caused 32% and 18.5% of nosocomial and community-acquired S. aureus bacteremias, respectively. The rates of both community-acquired and nosocomial S. aureus bacteremias have increased significantly since 1980. In addition to their role in nosocomial infections, MRSA and intravascular device-related S. aureus bacteremias are emerging problems in the nonhospital setting.
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Steinberg
authors.forename: C C
authors.initials: CC
authors.lastname: Clark
authors.forename: B O
authors.initials: BO
authors.lastname: Hackman
mesh_terms: D016470:Bacteremia / Q000382:microbiology / Q000635:transmission*; D002404:Catheterization; D017714:Community-Acquired Infections; D003428:Cross Infection; D006801:Humans; D016106:Methicillin Resistance; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*