Changing patterns of Staphylococcus aureus bacteremia

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Medical records of 1 34 patients with Staphylococcus aureus bacteremia at the Cincinnati General Hospital during 1975–1977 were reviewed. Bacteremia was community-acquired in 48 patients and hospital-acquired in 73 patients. In addition, 13 patients were on chronic hemodialysis. In 22 patients, bacteremia was associated with an infected intravenous catheter; all except one of these patients acquired the infection in the hospital. Thus 21 of 73 (29%) episodes of hospital-acquired S aureus bacteremia were associated with an infected intravenous catheter. Four of the 22 patients with intravenous catheter-associated bacteremia had endocarditis (18%). The overall incidence of endocarditis in this study was 16% (21 of 134 patients). This contrasted with the much higher incidence of endocarditis (64%) in Staphylococcal bacteremia reported from this same hospital in patients during 1940–1954.9 Possible reasons for this difference are discussed.

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