Epidemiology of Staphylococcus aureus bacteremia in adults

INTRODUCTION

Staphylococcus aureus is a leading cause of both community-acquired and healthcare-acquired bacteremia. Several important underlying conditions predispose patients to the development of S. aureus bacteremia (SAB). The morbidity and mortality of SAB is high even when appropriate therapy is given.

The presence of individual risk factors substantially affects clinical management. Thus, clinicians need to specifically inquire as to the presence or absence of these risk factors before making clinical decisions regarding treatment.

The epidemiology of and risk factors for SAB in adults will be reviewed here. The treatment of SAB is discussed separately. (See "Treatment of Staphylococcus aureus bacteremia in adults".)

EPIDEMIOLOGY

Bacteremia due to S. aureus can be classified into three categories: healthcare-associated hospital onset (nosocomial), community-acquired, and healthcare-associated community onset (non-nosocomial) (eg, long-term care facilities) [1]. In a prospective cohort study of 504 bloodstream infections (BSIs) seen at an academic center and two community hospitals in North Carolina between late 2000 and early 2001, 35 percent were nosocomial, 28 percent were community-acquired, and 37 percent were healthcare-associated community-onset [1]. Methicillin-resistant S. aureus accounted for most nosocomial and healthcare-associated community-onset infections (61 and 52 percent, respectively), but only a small proportion of community-acquired infections (14 percent).

Incidence — The incidence of SAB for all of the above categories has significantly increased over the last several decades. The following observations illustrate the range of findings:
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