Fortuin-de Smidt, Melony C.Singh-Moodley1, AshikaBadat, RubeinaQuan, VanessaKularatne, RanminiNana, TrushaLekalakala, M. RuthGovender, N.P. (Nelesh)Perovic, Olga2015-08-202015-08-202015-01Fortuin-de Smidt, MC, Singh-Moodley, A, Badat, R, Quan, V, Kularatne, R, Nana, T, Lekalakala, MR., Govender, NP & Perovic, O 2015, 'Staphylococcus aureus bacteraemia in Gauteng academic hospitals, South Africa', International Journal of Infectious Diseases, vol. 30, pp. 41-48.1201-9712 (print)1878-3511 (online)10.1016/j.ijid.2014.10.011http://hdl.handle.net/2263/49410INTRODUCTION : Methicillin-resistant Staphylococcus aureus (MRSA) infections are responsible for longer hospital stays, increased hospital costs, and poorer outcomes compared to methicillin-sensitive S. aureus (MSSA) infections. We aimed to describe the epidemiology of S. aureus bacteraemia (SAB) and to determine factors associated with MRSA infection in South Africa. METHODS : Cases of SAB were reported from September 2012 to September 2013 from three sentinel sites. A case was defined as the isolation of S. aureus from a blood culture during a 21-day period. Detailed clinical information was collected. Multivariable logistic regression was done to determine factors associated with MRSA infection and mortality. RESULTS : There were 442 cases of SAB reported; antimicrobial susceptibility testing was performed on 240 isolates (54%). Thirty-six percent (86/240) of cases had an MRSA infection. A longer hospital stay before positive specimen collection (odds ratio (OR) 1.08, 95% confidence interval (CI) 1.02–1.13, p = 0.004), hospitalization in the last year (OR 15.7, 95% CI 2.5–99.5, p = 0.003), HIV infection (OR 4.9, 95% CI 1.05–22.90, p = 0.044), and antibiotic use in the previous 2 months (OR 0.1, 95% CI 0.01–0.68, p = 0.022) were independent predictors of MRSA. Older age, and in particular age 25–44 years (OR 22.2, 95% CI 2.7–185.5, p = 0.004, compared to those aged < 5 years), was the only independent predictor of mortality amongst cases with SAB. MRSA isolates were non-susceptible to more antimicrobial agents compared to MSSA isolates. CONCLUSIONS : HIV infection was an independent risk factor for MRSA infection. The selection of appropriate empirical antimicrobial treatment is essential in patients with MRSA infections because of non-susceptibility to many other antimicrobial classes.en© 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).Staphylococcus aureusBacteraemiaMethicillin-resistantHIV infectionMortalityHuman immunodeficiency virus (HIV)Article