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Published on: December 4, 2020
Risk factors for recurrence and death after bacteraemia: a population-based study
U S Jensen1, J D Knudsen, S Wehberg
1Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen S, Denmark. uje@ssi.dk
Summary
Recurrent bacteremia (bloodstream infection) increases the risk of death. Identifying patients at risk for recurrent bloodstream infections can improve prevention and management strategies.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- While mortality is a primary focus in bloodstream infection (bacteremia) outcome studies, recurrent episodes represent a significant, yet often understudied, adverse outcome.
- Understanding the factors contributing to both recurrent bloodstream infections and mortality is crucial for comprehensive patient management and public health strategies.
Purpose of the Study:
- To characterize patient factors and microbial species associated with recurrence and death following bloodstream infections.
- To identify independent risk factors for recurrent bloodstream infections and mortality within one year of an initial episode.
Main Methods:
- A population-based surveillance study was conducted in a Canadian health region from 2000 to 2008.
- Episodes of bloodstream infection were extracted and characterized.
- Multivariate Cox proportional hazards models were used to estimate transition intensities for recurrence and death.
Main Results:
- Out of 9713 patients with incident bloodstream infections, 9.2% experienced recurrence within one year, 24.7% died without recurrence, and 3.4% died after a recurrent episode.
- Independent risk factors for recurrence included higher Charlson comorbidity scores, nosocomial or healthcare-associated infection origin, polymicrobial or fungal microorganisms, and specific infection foci (e.g., urogenital).
- A recurrent bloodstream infection was an independent risk factor for death within one year (hazard ratio: 3.6), alongside increasing age and infection focus.
Conclusions:
- This study identifies specific patient groups at elevated risk for recurrent bloodstream infections and subsequent mortality.
- Recurrent bloodstream infection is confirmed as an independent risk factor for death within one year.
- Findings can inform targeted prevention strategies and management modifications for patients with bloodstream infections.
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