Trends in S. aureus bacteremia 2001-2010: England compared with its Celtic neighbors

1. Trends in S. aureus bacteremia 2001-2010:England compared with its Celtic neighbors Rosy Reynolds, Russell Hopeon behalf ofthe BSAC Working Party on Resistance Surveillance K-948, 51st ICAAC, Chicago, 17 - 20 Sept 2011 rosy.reynolds@nbt.nhs.uk

2. Scotland N. Ireland England Wales Ireland • UK • England • Scotland • Wales • N. Ireland • Ireland Population (2009): England 51.8m Neighbours 14.5m

3. 2010 BSAC Bacteraemia Resistance Surveillance 2010 • 40 laboratories (was 25 up to 2009) • Target of 500 isolates of S. aureus /year from blood (was 250 up to 2007) • Central testing - • HPA Colindale, London. • BSAC agar dilution MICs and mecA test • Data on website: www.bsacsurv.org

4. ACKNOWLEDGEMENTS British Society for Antimicrobial Chemotherapy (BSAC) Bacteraemia Resistance Surveillance Programme HPA Colindale Sponsors 2001-2010 Collecting Laboratories

6. ?

7. OR for difference in slope = 1.21, p=0.004

8. Targeted interventions • Mandatory reporting (2001) • Care bundles • Hand hygiene / infection control • Mandatory admissions screening / decolonisation (2009) • Deep cleaning • Unintended effects / ecological pressures • Shorter hospital stays? • Changes in antibiotic use? • ???

9. Other information available Sex >99% Age >99% Care setting 99% (≥48 or <48 hours in hospital) Hospital speciality 90% Presumed focus of infection 63% (70 - 56%)

11. 7.6% of S. aureus bacteraemias were from ICU

14. Summary 1 MRSA stable around 42%, 2001 - 2006. % MRSA fell in ICUbefore 2006 (when stable in other specialities) % of reported line-relatedS. aureus bacteraemias fell before 2006 (but equally for MRSA and MSSA) Since 2006, widespread large reduction in MRSA bacteraemias (number and %).

15. Summary 2 • Drop in %MRSA since 2006 was • faster in England (to 14% vs. 28% by 2010) • but not affected by • age • sex • hospital-acquisition • hospital speciality • focus of infection Reasons are not clear.