The Burden of Staphylococcus aureus Infections on Hospitals in the United States

Noskin, Gary A.; Rubin, Robert J.; Schentag, Jerome J.; Kluytmans, Jan; Hedblom, Edwin C.; Smulders, Maartje; Lapetina, Elizabeth M.; Gemmen, Eric

doi:10.1001/archinte.165.15.1756

Cited by 256 publications

(91 citation statements)

References 28 publications

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“…The most commonly isolated microorganism in PJI after TJA is Staphylococcus aureus [22,29]. Resistant strains such as methicillin-resistant S aureus (MRSA) are on the rise [21] and are associated with higher rates of treatment failure [3,23].…”

Section: Introductionmentioning

confidence: 99%

Twenty Percent of Patients May Remain Colonized With Methicillin-resistant Staphylococcus aureus Despite a Decolonization Protocol in Patients Undergoing Elective Total Joint Arthroplasty

Baratz

Hallmark

Odum

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Staphylococcus aureus is the most commonly isolated organism in periprosthetic joint infection (PJI). Resistant strains such as methicillin-resistant S aureus (MRSA) are on the rise, and many programs have instituted decolonization protocols. There are limited data on the success of S aureus nasal decolonization programs and their impact on PJI. Questions/purposes The purposes of this study were to (1) determine the proportion of patients successfully decolonized using a 2-week protocol; (2) compare infection risks between our surveillance and decolonization protocol group against a historical control cohort to evaluate changes in proportions of S aureus infections; and (3) assess infection risk based on carrier type, comparing S aureus carriers with noncarrier controls. Methods We retrospectively evaluated a group of 3434 patients who underwent elective primary and revision hip and knee arthroplasty over a 2-year period; each patient in the treatment group underwent a surveillance protocol, and a therapeutic regimen of mupurocin and chlorhexidine was instituted when colonization criteria were met. A 2009 to 2010 comparative historical cohort was chosen as the control group. We compared risks of infection between our treatment group and the historical control cohort. Furthermore, in patients who developed surgical site infections (SSIs), we compared the proportions of each S aureus type between the two cohorts. Finally, we compared infection rates based on carrier status. Surveillance for infection was carried out by the hospital infection control coordinator using the Centers for Disease Control and Prevention (CDC) criteria. During the time period of this study, the CDC defined hospital-acquired infection related to a surgical procedure as any infection diagnosed within 1 year of the procedure. With the numbers available, we had 41% power to detect a difference of 0.3% in infection rate between the treatment and control groups. To achieve 80% power, a total of 72,033 patients would be needed.

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Section: Introductionmentioning

confidence: 99%

Twenty Percent of Patients May Remain Colonized With Methicillin-resistant Staphylococcus aureus Despite a Decolonization Protocol in Patients Undergoing Elective Total Joint Arthroplasty

Baratz

Hallmark

Odum

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Each year in the United States, more than 300,000 patients contract S. aureus infections, leading to more than 12,000 deaths, 2.7 million excess days of hospitalization, and close to $9.5 billion in excess hospital charges (8,11). Coagulase-negative staphylococci (CoNS) are the predominant organisms isolated from positive blood cultures (7), 60 to 80% of which are the result of contamination of the sample during the blood draw due to inadequate antiseptic techniques (2,17,21).…”

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confidence: 99%

Multicenter Evaluation of the Staphylococcus QuickFISH Method for Simultaneous Identification of Staphylococcus aureus and Coagulase-Negative Staphylococci Directly from Blood Culture Bottles in Less than 30 Minutes

Deck¹,

Anderson²,

Buckner

et al. 2012

J Clin Microbiol

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A novel rapid peptide nucleic acid fluorescence in situ hybridization (FISH) method, Staphylococcus Quick FISH, for the direct detection of Staphylococcus species from positive blood culture bottles was evaluated in a multicenter clinical study. The method utilizes a microscope slide with predeposited positive- and negative-control organisms and a self-reporting 15-min hybridization step, which eliminates the need for a wash step. Five clinical laboratories tested 722 positive blood culture bottles containing Gram-positive cocci in clusters. The sensitivities for detection of Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were 99.5% (217/218) and 98.8% (487/493), respectively, and the combined specificity of the assay was 89.5% (17/19). The combined positive and negative predictive values of the assay were 99.7% (696/698) and 70.8% (17/24), respectively. Studies were also performed on spiked cultures to establish the specificity and performance sensitivity of the method. Staphylococcus Quick FISH has a turnaround time (TAT) of <30 min and a hands-on time (HOT) of <5 min. The ease and speed of the method have the potential to improve the accuracy of therapeutic intervention by providing S. aureus /CoNS identification simultaneously with Gram stain results.

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“…Several populationbased studies on S. aureus infections exist; however, these studies focused on hospital-based populations (3)(4)(5)(6), MRSA infection (7-9), non-US populations (10)(11)(12), or only estimated the impact of invasive S. aureus disease (10,(13)(14)(15). Additionally, population-level changes in incidence, particularly before and after USA300 MRSA emerged, are largely unknown.…”

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confidence: 99%

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Salam¹,

Khan²,

Malnick³

et al. 2011

Emerg. Infect. Dis.

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Trends in Staphylococcus aureus infections are not well described. To calculate incidence in overall S. aureus infection and invasive and noninvasive infections according to methicillin susceptibility and location, we conducted a 10-year population-based retrospective cohort study (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) using patient-level data in the Veterans Affairs Maryland Health Care System. We found 3,674 S. aureus infections: 2,816 (77%) were noninvasive; 2,256 (61%) were methicillin-resistant S. aureus (MRSA); 2,517 (69%) were community onset, and 1,157 (31%) were hospital onset. Sixty-one percent of noninvasive infections were skin and soft tissue infections; 1,112 (65%) of these were MRSA. Ten-year averaged incidence per 100,000 veterans was 749 (± 132 SD,

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The Burden of Staphylococcus aureus Infections on Hospitals in the United States

Cited by 256 publications

References 28 publications

Twenty Percent of Patients May Remain Colonized With Methicillin-resistant Staphylococcus aureus Despite a Decolonization Protocol in Patients Undergoing Elective Total Joint Arthroplasty

Twenty Percent of Patients May Remain Colonized With Methicillin-resistant Staphylococcus aureus Despite a Decolonization Protocol in Patients Undergoing Elective Total Joint Arthroplasty

Multicenter Evaluation of the Staphylococcus QuickFISH Method for Simultaneous Identification of Staphylococcus aureus and Coagulase-Negative Staphylococci Directly from Blood Culture Bottles in Less than 30 Minutes

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

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