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Clin Infect Dis. 2014 Oct;59(7):969-75. doi: 10.1093/cid/ciu508. Epub 2014 Jun 27.

A major reduction in hospital-onset Staphylococcus aureus bacteremia in Australia-12 years of progress: an observational study.

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Faculty of Nursing and Health, Avondale College for Higher Education, Wahroonga, New South Wales School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Dickson.
Canberra Hospital and Medical School, Australian National University, Canberra, Australian Capital Territory.
Healthcare Associated Infection Unit, Department of Health, Perth, Western Australia.
Infection Control Service, Department of Health, Adelaide, South Australia.
Tasmanian Infection Prevention and Control Unit, Department of Health and Human Services, Hobart, Tasmania, Australia.



Staphylococcus aureus bacteremia (SAB) is a serious cause of morbidity and mortality. This longitudinal study describes significant reductions in hospital-onset SAB (HO-SAB) in Australian hospitals over the past 12 years.


An observational cohort study design was used. Prospective surveillance of HO-SAB in 132 hospitals in Australia was undertaken. Aggregated data from all patients who acquired HO-SAB was collected (defined as 1 or more blood cultures positive for S. aureus taken from a patient who had been admitted to hospital for >48 hours). The primary outcome was the incidence of HO-SAB, including both methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) S. aureus strains.


A total of 2733 HO-SAB cases were identified over the study period, giving an aggregate incidence of 0.90 per 10 000 patient-days (PDs) (95% confidence interval [CI], .86-.93). There was a 63% decrease in the annual incidence, from 1.72 per 10 000 PDs in 2002 (95% CI, 1.50-1.97) to 0.64 per 10 000 PDs (95% CI, .53-.76) in 2013. The mean reduction per year was 9.4% (95% CI, -8.1% to -10.7%). Significant reductions in both HO-MRSA (from 0.77 to 0.18 per 10 000 PDs) and HO-MSSA (from 1.71 to 0.64 per 10 000 PDs) bacteremia were observed.


There was a major and significant reduction in incidence of HO-SAB caused by both MRSA and MSSA in Australian hospitals since 2002. This reduction coincided with a range of infection prevention and control activities implemented during this time. It suggests that national and local efforts to reduce the burden of healthcare-associated infections have been very successful.


Staphylococcus aureus; bacteremia; bloodstream infection; healthcare-associated infections; infection control

[Indexed for MEDLINE]

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