Community and hospital acquired Staphylococcus aureus septicaemia: 115 cases from a Dublin teaching hospital

Despite advances in diagnostic techniques and antimicrobials, septicaemia due to Staphylococcus aureus remains a common clinical problem with a significant mortality. We retrospectively compared community and hospital acquired cases of S. aureus septicaemia occurring in our 600 bed teaching hospital over a 30 month period. Of 110 episodes 32 (29%) were community acquired and 78 (71%) hospital acquired. A likely primary source was identified in 14 (44%) of community acquired cases and in 73 (94%) of hospital acquired cases. A secondary focus of infection was more common in community acquired cases (17, 53%) than hospital acquired cases (5, 6%). Mortality was significantly higher in community acquired cases (22% vs. 6%). An association was also found between the presence of endocarditis and increased mortality, although this did not reach significance. We also compared hospital acquired septicaemia due to methicillin sensitive and methicillin resistant S. aureus found a significantly higher mortality in the methicillin resistant group (22% vs. 3%, P < 0.05). S. aureus septicaemia remains an important cause of morbidity and mortality, particularly when associated with secondary foci of infection. This study also emphasises the importance of control of methicillin resistant strains in hospital.