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Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008

BACKGROUND: The objective of this study was to assess temporal changes in incidence and short term mortality of Staphylococcus aureus bacteraemia (SAB) from 1995 through 2008. METHODS: The study was conducted as a nation-wide observational cohort study with matched population controls. The setting w...

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Autores principales: Mejer, Niels, Westh, Henrik, Schønheyder, Henrik C, Jensen, Allan G, Larsen, Anders R, Skov, Robert, Benfield, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507819/
https://www.ncbi.nlm.nih.gov/pubmed/23075215
http://dx.doi.org/10.1186/1471-2334-12-260
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author Mejer, Niels
Westh, Henrik
Schønheyder, Henrik C
Jensen, Allan G
Larsen, Anders R
Skov, Robert
Benfield, Thomas
author_facet Mejer, Niels
Westh, Henrik
Schønheyder, Henrik C
Jensen, Allan G
Larsen, Anders R
Skov, Robert
Benfield, Thomas
author_sort Mejer, Niels
collection PubMed
description BACKGROUND: The objective of this study was to assess temporal changes in incidence and short term mortality of Staphylococcus aureus bacteraemia (SAB) from 1995 through 2008. METHODS: The study was conducted as a nation-wide observational cohort study with matched population controls. The setting was hospitalized patients in Denmark 1995-2008. Uni- and multivariate analyses were used to analyze the hazard of death within 30 days from SAB. RESULTS: A total of 16 330 cases of SAB were identified: 57% were hospital-associated (HA), 31% were community-acquired (CA) and 13% were of undetermined acquisition. The overall adjusted incidence rate remained stable at 23 per 100 000 population but the proportion of SAB cases older than 75 years increased significantly. Comorbidity in the cohort as measured by Charlson comorbidity index (CCI) score and alcohol-related diagnoses increased over the study period. In contrast, among the population controls the CCI remained stable and alcohol-related diagnoses increased slightly. For HA SAB crude 30-day mortality decreased from 27.8% to 21.8% (22% reduction) whereas the change for CA SAB was small (26.5% to 25.8%). By multivariate Cox regression, age, female sex, time period, CCI score and alcohol-related diagnoses were associated with increased mortality regardless of mode of acquisition. CONCLUSIONS: Throughout a 14-year period the overall incidence of SAB remained stable while the overall short term prognosis continued to improve despite increased age and accumulation of comorbidity in the cohort. However, age and comorbidity were strong prognostic indicators for short term mortality.
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spelling pubmed-35078192012-11-28 Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008 Mejer, Niels Westh, Henrik Schønheyder, Henrik C Jensen, Allan G Larsen, Anders R Skov, Robert Benfield, Thomas BMC Infect Dis Research Article BACKGROUND: The objective of this study was to assess temporal changes in incidence and short term mortality of Staphylococcus aureus bacteraemia (SAB) from 1995 through 2008. METHODS: The study was conducted as a nation-wide observational cohort study with matched population controls. The setting was hospitalized patients in Denmark 1995-2008. Uni- and multivariate analyses were used to analyze the hazard of death within 30 days from SAB. RESULTS: A total of 16 330 cases of SAB were identified: 57% were hospital-associated (HA), 31% were community-acquired (CA) and 13% were of undetermined acquisition. The overall adjusted incidence rate remained stable at 23 per 100 000 population but the proportion of SAB cases older than 75 years increased significantly. Comorbidity in the cohort as measured by Charlson comorbidity index (CCI) score and alcohol-related diagnoses increased over the study period. In contrast, among the population controls the CCI remained stable and alcohol-related diagnoses increased slightly. For HA SAB crude 30-day mortality decreased from 27.8% to 21.8% (22% reduction) whereas the change for CA SAB was small (26.5% to 25.8%). By multivariate Cox regression, age, female sex, time period, CCI score and alcohol-related diagnoses were associated with increased mortality regardless of mode of acquisition. CONCLUSIONS: Throughout a 14-year period the overall incidence of SAB remained stable while the overall short term prognosis continued to improve despite increased age and accumulation of comorbidity in the cohort. However, age and comorbidity were strong prognostic indicators for short term mortality. BioMed Central 2012-10-17 /pmc/articles/PMC3507819/ /pubmed/23075215 http://dx.doi.org/10.1186/1471-2334-12-260 Text en Copyright ©2012 Mejer et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Mejer, Niels
Westh, Henrik
Schønheyder, Henrik C
Jensen, Allan G
Larsen, Anders R
Skov, Robert
Benfield, Thomas
Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008
title Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008
title_full Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008
title_fullStr Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008
title_full_unstemmed Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008
title_short Stable incidence and continued improvement in short term mortality of Staphylococcus aureus bacteraemia between 1995 and 2008
title_sort stable incidence and continued improvement in short term mortality of staphylococcus aureus bacteraemia between 1995 and 2008
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507819/
https://www.ncbi.nlm.nih.gov/pubmed/23075215
http://dx.doi.org/10.1186/1471-2334-12-260
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