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Staphylococcus aureus Bacteremia Incidence and Methicillin Resistance in Rural Thailand, 2006-2014

Devan Jaganath1,2, Possawat Jorakate2, Sirirat Makprasert2

  • 1Division of Pediatric Infectious Diseases, Department of Pediatrics, University of California San Francisco, San Francisco, California.

The American Journal of Tropical Medicine and Hygiene
|May 16, 2018
PubMed

Insights

Community-onset Staphylococcus aureus bacteremia (SAB) incidence has doubled in Thailand, particularly affecting older adults and neonates. Methicillin-resistant S. aureus (MRSA) rates remained stable, highlighting the need for robust surveillance.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Antimicrobial Resistance

Background:

  • Staphylococcus aureus bloodstream infections (SAB) are a significant public health concern.
  • Methicillin-resistant S. aureus (MRSA) poses a growing global threat.
  • Understanding SAB and MRSA incidence trends is crucial for effective public health strategies.

Purpose of the Study:

  • To evaluate the incidence rates of Staphylococcus aureus bacteremia (SAB) and MRSA in two Thai provinces.
  • To analyze trends in community-onset (CO) and hospital-onset (HO) SAB.
  • To assess the prevalence of MRSA among SAB cases.

Main Methods:

  • Population-based surveillance was conducted across all hospitals in two Thai provinces.
  • Blood cultures were analyzed to identify SAB cases.
  • Infections were classified as CO (≤2 days post-admission) or HO (>2 days post-admission).
  • Incidence rates were calculated using person-years and hospitalizations as denominators.

Main Results:

  • The incidence rate of CO-SAB doubled from 4.4 to 9.3 per 100,000 persons per year between 2006 and 2014.
  • The highest CO-SAB rates were observed in adults aged 50+ and children under 5 (especially neonates).
  • MRSA prevalence was 10% overall, with higher rates in HO-SAB (20%) compared to CO-SAB (7%).
  • HO-SAB incidence rate was 0.13 per 1,000 hospitalizations (2009-2014).

Conclusions:

  • The incidence of community-onset SAB has significantly increased in Thailand.
  • Methicillin-resistant S. aureus (MRSA) incidence has remained stable.
  • The rising CO-SAB burden, especially in vulnerable populations, necessitates enhanced surveillance for bacteremia and antimicrobial resistance trends.

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