The Scottish enhanced Staphylococcus aureus bacteraemia surveillance program

Staphylococcus aureus bacteraemia (SAB) is the second most common source of positive blood cultures after Escherichia coli (E. coli) reported within NHS Scotland. Laboratory surveillance has been mandatory in Scotland for SAB since 2001 | Journal of Hospital Infection

Aim: To gain an understanding of the epidemiology of SAB cases and associated risk factors for healthcare and true community onset. Identifying these factors and patient populations most at risk allows focused improvement plans to be developed.

Methods: All NHS Boards within NHS Scotland take part in the mandatory enhanced surveillance collecting data by trained data collectors using nationally agreed definitions.

Findings: Between 1st October 2014 and 31st March 2016, 2256 episodes of SAB in adults were identified. The blood cultures were taken in 58 hospitals and across all 15 Scottish health boards. The data demonstrated that approximately one third of all SAB cases are true community cases. Vascular access devices (VAD) continue to be the most reported entry point (25.7%) in persons who receive healthcare, whereas, skin and soft tissue risk factors are present in all origins. A significant risk factor unique to community cases are in people who inject drugs (PWID).

Conclusion: Improvement plans for reduction of SAB should be more widely targeted than solely in hospital care settings.

Full reference: Murdoch, F. et al. (2017) The Scottish enhanced Staphylococcus aureus bacteraemia surveillance program: The first 18 months data in adults. Journal of Hospital Infection. Published online: June 08, 2017

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Screening test recommendations for methicillin-resistant Staphylococcus aureus surveillance practices

Whittington, M.D. et al. American Journal of Infection Control. Published online: 23 January 2017

Highlights: 

  • Rapid screening tests reduce unnecessary surveillance costs.
  • Using polymerase chain reaction with universal preemptive isolation minimizes total costs.
  • Using chromogenic agar 24-hour with targeted isolation minimizes total costs.
  • Although polymerase chain reaction minimized inappropriate costs, the added cost per test was only offset with universal preemptive isolation.

Read the full abstract here