14-Year Survey in a Swedish County Reveals a Pronounced Increase in Bloodstream Infections BSI. Comorbidity - An Independent Risk Factor for Both BSI and MortalityReport as inadecuate




14-Year Survey in a Swedish County Reveals a Pronounced Increase in Bloodstream Infections BSI. Comorbidity - An Independent Risk Factor for Both BSI and Mortality - Download this document for free, or read online. Document in PDF available to download.

Objectives

we assessed the incidence, risk factors and outcome of BSI over a 14-year period 2000–2013 in a Swedish county.

Methods

retrospective cohort study on culture confirmed BSI among patients in the county of Östergötland, Sweden, with approximately 440,000 inhabitants. A BSI was defined as either community-onset BSI CO-BSI or hospital-acquired BSI HA-BSI.

Results

of a total of 11,480 BSIs, 67% were CO-BSI and 33% HA-BSI. The incidence of BSI increased by 64% from 945 to 1,546 per 100,000 hospital admissions per year during the study period. The most prominent increase, 83% was observed within the CO-BSI cohort whilst HA-BSI increased by 32%. Prescriptions of antibiotics in outpatient care decreased with 24% from 422 to 322 prescriptions dispensed-1,000 inhabitants-year, whereas antibiotics prescribed in hospital increased by 67% from 424 to 709 DDD per 1,000 days of care. The overall 30-day mortality for HA-BSIs was 17.2%, compared to 10.6% for CO-BSIs, with an average yearly increase per 100,000 hospital admissions of 2 and 5% respectively. The proportion of patients with one or more comorbidities, increased from 20.8 to 55.3%. In multivariate analyses, risk factors for mortality within 30 days were: HA-BSI 2.22; two or more comorbidities 1.89; single comorbidity 1.56; CO-BSI 1.21; male 1.05; and high age 1.04.

Conclusion

this survey revealed an alarming increase in the incidence of BSI over the 14-year study period. Interventions to decrease BSI in general should be considered together with robust antibiotic stewardship programmes to avoid both over- and underuse of antibiotics.



Author: Martin Holmbom, Christian G. Giske, Mats Fredrikson, Åse Östholm Balkhed, Carina Claesson, Lennart E. Nilsson, Mikael Hoffmann,

Source: http://plos.srce.hr/



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