Trends among pathogens reported as causing bacteraemia in England, 2004-2008

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Public Health Surveillance

Background:

• Bacteraemia, a bloodstream infection, poses a significant health risk.
• Understanding trends in causative microorganisms is crucial for effective public health interventions.
• England's voluntary surveillance system collects data from over 90% of laboratories.

Purpose of the Study:

• To analyze trends in causative microorganisms of bacteraemia in England between 2004 and 2008.
• To identify shifts in the prevalence of specific pathogens and associated risk factors.
• To inform public health strategies for combating bacteraemia.

Main Methods:

• Analysis of voluntary surveillance data on bacteraemia from English laboratories (2004-2008).
• Utilized a generalized linear model with a log link function for Poisson distribution to analyze trends.
• Categorized microorganisms including Escherichia coli, coagulase-negative staphylococci (CNS), and Staphylococcus aureus.

Main Results:

• In 2008, 101,276 bacteraemia episodes were reported (189 per 100,000 population), predominantly in individuals over 65 and males.
• Escherichia coli bacteraemia increased by 33% (p < 0.001) between 2004-2008, exceeding 30% in those over 75.
• Significant increases in Gram-negative pathogens and seasonal variations were observed. Staphylococcus aureus bacteraemia declined post-2006 due to methicillin-resistant strains, while CNS bacteraemia declined since 2007.

Conclusions:

• A concerning resurgence of Gram-negative pathogens causing bacteraemia in England is evident.
• These pathogens are linked to high morbidity and increasing antibiotic resistance, necessitating further research.
• Declines in methicillin-resistant Staphylococcus aureus have not been mirrored in other pathogens, highlighting the need for targeted prevention strategies.