title: Epidemiology and outcomes of community-onset methicillin-susceptible Staphylococcus aureus bacteraemia in a university hospital in Singapore.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. u0306523@nus.edu.sg
authors.forename: Jonathan Wei-Zhong
authors.initials: JW
authors.lastname: Chia
authors.forename: Li-Yang
authors.initials: LY
authors.lastname: Hsu
authors.forename: Louis Yi-Ann
authors.initials: LY
authors.lastname: Chai
authors.forename: Paul Ananth
authors.initials: PA
authors.lastname: Tambyah
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008712:Methicillin / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin