Staphylococcus aureus bloodstream infection: Secular changes associated with the implementation of a de novo clinical infectious diseases service in a Canadian population.

OBJECTIVE:To investigate the epidemiology of Staphylococcus aureus bloodstream infections (BSI) in a mixed rural to small city population and examine secular changes associated with the implementation of a regional clinical infectious diseases program. METHODS:Population-based surveillance for incident S. aureus BSI was conducted in the western interior of British Columbia, Canada between April 2010 and March 2020. An infectious diseases service was progressively implemented starting in 2013. RESULTS:581 incident S. aureus BSI were identified. There was an increasing incidence during the study and the overall age- and gender-adjusted annual rate was 32.9 per 100,000 population. Implementation of the infectious diseases program was associated with an increase in rates of blood culture sampling, documentation of persistent bacteremia, use of transthoracic and transesophageal echocardiography, and a reduction in cases of relapsed BSI. Infectious diseases consultation was independently associated with a reduced risk for death (odds ratio 0.5; 95% CI 0.3-0.9). CONCLUSIONS:Although the implementation of a clinical infectious diseases service was associated with changes in management and improved outcome, S. aureus BSI still causes a major burden of illness.