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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Infectious Diseases 1/2017

Burden of bloodstream infection in an area of Mid-Norway 2002-2013: a prospective population-based observational study

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2017
Autoren:
Arne Mehl, Bjørn Olav Åsvold, Stian Lydersen, Julie Paulsen, Erik Solligård, Jan Kristian Damås, Stig Harthug, Tom-Harald Edna
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12879-017-2291-2) contains supplementary material, which is available to authorized users.

Abstract

Background

Studies from several countries indicate that the incidence and mortality of bloodstream infection (BSI) have been increasing over time.

Methods

We studied the burden of disease and death related to BSI in a defined geographical area of Mid-Norway, where BSI episodes were prospectively recorded by the same microbiological department during 12 consecutive years. Death from BSI was defined as death within 30 days of BSI detection. Age and sex standardized incidence and mortality rates and case fatality rates were calculated.

Results

Between 2002 and 2013, 1995 episodes of BSI in 1719 patients aged 16 to 99 years were included. The overall incidence of BSI was 215 per 100,000 person-years. The incidence increased exponentially with age, particularly in males. The incidence increased from 205 to 223 per 100,000 person-years from 2002–07 to 2008–13. Escherichia coli was the most frequently isolated infective agent, followed by Streptococcus pneumoniae and Staphylococcus aureus. The rate of S. pneumoniae BSI decreased over time in males (on average by 9.2% annually), but not in females. The total rate of BSI microbes with acquired resistance increased slightly over time, but did not exceed 2 episodes per 100,000 person-years. The mortality of BSI was 32 per 100,000 person-years, higher in males than in females (36 vs. 28 per 100,000 person-years) and was significantly higher in old age, particularly in males. The total BSI mortality was similar in the first and second halves of the study period, but the mortality of S. pneumoniae BSI decreased in males (15.0% annually). The crude case fatality decreased from the first to the second half of the study period (17.2% to 13.1%; p = 0.014). The rate of blood culture sampling increased more than twofold during the study period.

Conclusions

The mortality of BSI remained stable during 2002–2013. At the same time, BSI incidence increased and case fatality rate decreased, perhaps because an increased rate of blood culture sampling may have led to improved detection of milder BSI episodes. Very low, yet slightly increasing rates of microbes with acquired resistance were observed.
Zusatzmaterial
Additional file 1: Table S1. Incidence of bloodstream infection in 5-year age groups stratified by sex. Table S2. Incidence and mortality of hospital acquired bloodstream infection. Table S3. Incidence of bloodstream infection and blood culture sampling by calendar year. Table S4. Incidence and mortality of hospital acquired bloodstream infection in 2002–2007 compared to 2008–2013. Table S5. Less common bloodstream infection microbes in two time periods in an area of Mid-Norway. Table S6. Mortality of bloodstream infection in 5-year age groups stratified by sex. Table S7. Mortality of bloodstream infection with less common microbes. Table S8. Case fatality rate of bloodstream infection in two time periods. Table S9. Rate of blood culture sampling in 2002–2007 compared to 2008–2013. (DOCX 60 kb)
12879_2017_2291_MOESM1_ESM.docx
Literatur
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