Staphylococcus aureus bacteraemia surveillance: a relatively easy to collect but accurate clinical indicator on serious health-care associated infections and antibiotic resistance

Staphylococcus aureus bloodstream (SAB) infections are common and serious causes of morbidity and mortality worldwide. Approximately one half of all SAB episodes have a hospital onset. In the remainder, the patients are living in the community when they become ill (i.e. community onset); of these, about one third are related to health care procedures. These SAB episodes are associated with a high mortality, yet many are potentially preventable.

At The Canberra Hospital (TCH) there have been 2193 cases of ’significant’ blood stream infection (BSI) since 1998. Of these, 470 were caused by Staphylococcus aureus. Intravenous catheters (IV) were the most frequent cause of these episodes (152 episodes). Following the introduction of our ’whole of hospital’ BSI surveillance programme, we have seen the number of IV catheter associated BSIs drop from 109 episodes in 1998 to 42 episodes in 2004 (all microorganisms). IV catheter episodes due to SAB have dropped from 26 per year in 1998 to 14 in 2004.

Data on all SAB episodes are relatively easy to collect and will also let us measure what is happening with methicillin resistant S. aureus (MRSA). When individual hospitals look for the causes for health care associated SAB, this will identify preventable factors. This should result in changes in clinical practices and protocols in those hospitals. We will then see a fall in the numbers of these serious and lifethreatening infections in Australia.