MRSA infections in smaller hospitals, Victoria, Australia

Bennett, Noleen; Bull, Ann; Dunt, David; Gurrin, Lyle C.; Spelman, Denis; Russo, Philip L.; Richards, Michael J.

doi:10.1016/j.ajic.2006.12.011

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Antimicrobial-resistant (AMR) pathogens responsible for SSIs displayed significant trends over time. We observed a reduction in infections due to MRSA, recognizing that widespread reductions in bloodstream infections due to S. aureus and MRSA 23 and low rates of MRSA nonsurgical wound infection in smaller hospitals 24 have previously been reported in Victoria. The factors contributing to a reduction in MRSA SSIs are not clear and require further study.…”

Section: Discussionsupporting

confidence: 66%

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Worth

Bull

Spelman

et al. 2015

Infect. Control Hosp. Epidemiol.

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OBJECTIVETo evaluate time trends in surgical site infection (SSI) rates and SSI pathogens in Australia.DESIGNProspective multicenter observational cohort study.SETTINGA group of 81 Australian healthcare facilities participating in the Victorian Healthcare Associated Infection Surveillance System (VICNISS).PATIENTSAll patients underwent surgeries performed between October 1, 2002, and June 30, 2013. National Healthcare Safety Network SSI surveillance methods were employed by the infection prevention staff at the participating hospitals.INTERVENTIONProcedure-specific risk-adjusted SSI rates were calculated. Pathogen-specific and antimicrobial-resistant (AMR) infections were modeled using multilevel mixed-effects Poisson regression.RESULTSA total of 183,625 procedures were monitored, and 5,123 SSIs were reported. Each year of observation was associated with 11% risk reduction for superficial SSI (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.88–0.90), 9% risk reduction for deep SSI (RR, 0.91; 95% CI, 0.90–0.93), and 5% risk reduction for organ/space SSI (RR, 0.95; 95% CI, 0.93–0.97). Overall, 3,318 microbiologically confirmed SSIs were reported. Of these SSIs, 1,174 (35.4%) were associated with orthopedic surgery, 827 (24.9%) with coronary artery bypass surgery, 490 (14.8%) with Caesarean sections, and 414 (12.5%) with colorectal procedures. Staphylococcus aureus was the most frequently identified pathogen, and a statistically significant increase in infections due to ceftriaxone-resistant Escherichia coli was observed (RR, 1.37; 95% CI, 1.10–1.70).CONCLUSIONSStandardized SSI surveillance methods have been implemented in Victoria, Australia. Over an 11-year period, diminishing rates of SSIs have been observed, although AMR infections increased significantly. Our findings facilitate the refinement of recommended surgical antibiotic prophylaxis regimens and highlight the need for a more expansive national surveillance strategy to identify changes in epidemiology.Infect Control Hosp Epidemiol 2015;00(0): 1–8

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Section: Discussionsupporting

confidence: 66%

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Worth

Bull

Spelman

et al. 2015

Infect. Control Hosp. Epidemiol.

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“…Data used to estimate incidence was either: incidence of CO-MRSA, [18, 32, 33] numbers of CO-MRSA infections in a given period of time, [20, 34–36] numbers of MRSA infections and proportions that were nosocomial or CO, with and without HAI risk factors or, finally, the number of CO S. aureus infections and the proportion of those that were MRSA.…”

Section: Resultsmentioning

confidence: 99%

Incidence of community onset MRSA in Australia: least reported where it is Most prevalent

Cameron

Hall

Tong

et al. 2019

Antimicrob Resist Infect Control

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BackgroundThis is the first review of literature and synthesis of data on community onset methicillin resistant Staphylococcus aureus (CO-MRSA) infections in Australia. Incidence of CO-MRSA varies considerably in Australia, depending on geographic and demographic factors.MethodsData for the rates of MRSA infections were collected from articles identified using PubMed, Scopus, the grey literature and data from State and Federal Government Surveillance Systems. We synthesized data and developed a framework for how data was selected, collated, linked, organized and interpreted.ResultsThe results of our literature search demonstrates considerable gaps in the reporting of CO-MRSA in Australia. Consequently, total incidences were under reported; however the available data suggests the incidence varied between 44 (Tasmania) and 388 (southern Northern Territory) cases per 100,000 person years. Hospitalised cases of CO-MRSA varied between 3.8 (regional Victoria) and 329 (southern Northern Territory). Taking the median percentage of infections by site for all regions available, skin and soft tissue infections (SSTIs) consisted of 56% of hospitalized CO-MRSA, compared with bacteremias, which represented 14%. No region had a complete data set of CO-MRSA infections treated in out-patient settings and so incidences were underestimates. Nevertheless, estimates of the incidence of CO-MRSA treated outside hospitals varied between 11.3 (Melbourne) and 285 (Northern Territory) per 100,000 person-years. These infections were chiefly SSTIs, although urinary tract infections were also noted.Incidences of CO-MRSA blood-stream infections and outpatient skin and soft tissue infections have been increasing with time, except in Tasmania. CO-MRSA is observed to affect people living in remote areas and areas of socioeconomic disadvantage disproportionately.ConclusionsWe generated the first estimates of the incidence of CO-MRSA infections in Australia and identified stark regional differences in the nature and frequency of infections. Critically, we demonstrate that there has been a lack of consistency in reporting CO-MRSA and a general dearth of data. The only government in Australia that requires reporting of CO-MRSA is the Tasmanian, where the infection was least prevalent. Some regions of Australia have very high incidences of CO-MRSA. To improve surveillance and inform effective interventions, we recommend a standardized national reporting system in Australia that reports infections at a range of infection sites, has broad geographic coverage and consistent use of terminology. We have identified limitations in the available data that hinder understanding the prevalence of CO-MRSA.Electronic supplementary materialThe online version of this article (10.1186/s13756-019-0485-7) contains supplementary material, which is available to authorized users.

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MRSA infections in smaller hospitals, Victoria, Australia

Cited by 2 publications

References 7 publications

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Incidence of community onset MRSA in Australia: least reported where it is Most prevalent

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