title: Characteristics of invasive Staphylococcus aureus infections in three regions of Korea, 2009-2011: a multi-center cohort study.
abstract: BACKGROUND
  Despite the importance of invasive Staphylococcus aureus (ISA) infection, its overall burden in non-selected populations has only been defined in a small number of studies in Europe and North America. To define the characteristics of ISA infections in Korea, we conducted a multi-center cohort study to estimate population-based incidence rates.
  
  
  METHODS
  We conducted a multicenter prospective cohort study at nine university-affiliated active-surveillance core centers (ASCs) in three regions of Korea. To cover all available clinical microbiologic laboratories, we classified the laboratories in these regions into three groups according to their clinical environment as: 1) Nine ASCs, 2) Five major commercial laboratories and 3) Forty-four acute-care hospital-affiliated microbiology laboratories. We requested all the laboratories to report prospectively their numbers of cases of S. aureus isolated from normally sterile sites. Detailed clinical information was collected about the cases in the nine ASCs.
  
  
  RESULTS
  From 1 July 2009 to 30 June 2011, a total of 1,198 cases of ISA infection were identified at the nine ASCs, including 748 (62%) methicillin-resistant S. aureus (MRSA) infections. Most (81%) ISA infections were healthcare-associated (HCA): 653 (55%) hospital-onset and 322 (27%) community-onset. 223 (19%) were community-associated infections. The most common primary diagnosis was catheter-associated infection (225 cases, 19%). Respiratory tract infection (160, 13%), skin & soft tissue (152, 13%) and bone & joint infections (120, 10%) were also common. 30-day and 12-week mortality rates were 25.6% (262/1,024) and 36.5% (314/860), respectively. Complications, including metastatic infection within 12 weeks, occurred in 17.8% of ISA infections. The most common site of metastatic infection was the lung (9.8%, 84/860). Based on the total of 2,806 observed cases of ISA infection, estimated annual rates of ISA and invasive MRSA infections were 43.3 and 27.7 per 100,000 populations, respectively.
  
  
  CONCLUSIONS
  Our data provide important information about the clinical characteristics of ISA infections. We estimate that over 21,000 ISA infections and 13,000 invasive MRSA infections occurred in Korea in 2010.
authors: Kyoung-Ho
authors: KH
authors: Song
authors: Eu Suk
authors: ES
authors: Kim
authors: Hye-Yun
authors: HY
authors: Sin
authors: Kyung-Hwa
authors: KH
authors: Park
authors: Sook-In
authors: SI
authors: Jung
authors: Nara
authors: N
authors: Yoon
authors: Dong-Min
authors: DM
authors: Kim
authors: Chang Seop
authors: CS
authors: Lee
authors: Hee-Chang
authors: HC
authors: Jang
authors: Yoonseon
authors: Y
authors: Park
authors: Kkot Sil
authors: KS
authors: Lee
authors: Yee Gyung
authors: YG
authors: Kwak
authors: Jae Hoon
authors: JH
authors: Lee
authors: Seong Yeon
authors: SY
authors: Park
authors: Minkyo
authors: M
authors: Song
authors: Sue K
authors: SK
authors: Park
authors: Yeong-Seon
authors: YS
authors: Lee
authors: Department of Internal Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Seongnam, Bundang-gu 463-707, Republic of Korea. hbkimmd@snu.ac.kr.
authors: Hong Bin
authors: HB
authors: Kim
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents