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Published on: February 10, 2011
Population-based study of Morganella-Proteus-Providencia group bloodstream infections
Kevin B Laupland1,2,3, Kelsey Pasquill4, Lisa Steele4
1Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Background:
There is a paucity of studies investigating the population-based epidemiology of Morganella-Proteus-Providencia (MPP) group infections. Our objective was to determine the incidence, risk factors, and outcome of MPP group bloodstream infections (BSI), and explore species-specific differences.
Methods:
Population-based surveillance was conducted in the western interior of British Columbia, Canada, between April 1, 2010 and March 30, 2020.
Results:
Sixty-two incident MPP group BSI occurred for an annual incidence of 3.4 per 100,000 residents; rates for Morganella morganii, Proteus mirabilis, and Providencia species were 0.5, 2.6, and 0.3 per 100,000 population, respectively. The median year of age was 72.5 and was different (p = 0.03) among the groups. Most (92%) MPP group BSIs were of community-onset. Significant differences were observed in the distribution of clinical focus of infection, with most notably 81% of P. mirabilis BSI due to genitourinary focus as compared to 60% and 22% for Providencia species and M. morganii, respectively. Comorbid illnesses that increased the risk for development of MPP group BSI (incidence rate ratio; 95% CI) were HIV infection (37.0; 4.4-139.6), dementia (11.5; 6.1-20.7), cancer (6.4; 3.2-11.9), stroke 6.5 (2.8-13.3), and diabetes 2.7 (1.3-5.0). Thirteen, one, and none of the cases with P. mirabilis, M. morganii, and Providencia species BSI died within 30 days of index culture for respective all cause case-fatalities of 27%, 11%, and 0% (p = 0.1).
Conclusions:
Although collectively responsible for a substantial burden of illness, the epidemiology of MPP group BSI varies significantly by species.
Insights
This study reveals that bloodstream infections (BSIs) from Morganella-Proteus-Providencia (MPP) bacteria are uncommon but serious. Epidemiology and outcomes of MPP BSIs differ significantly by species, highlighting the need for species-specific management strategies.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Limited population-based data exists on the epidemiology of Morganella-Proteus-Providencia (MPP) group infections.
- These bacteria are an understudied group of Gram-negative pathogens.
- Understanding their epidemiology is crucial for public health.
Purpose of the Study:
- To determine the incidence, risk factors, and outcomes of MPP group bloodstream infections (BSIs).
- To explore species-specific differences in MPP BSI epidemiology.
- To inform clinical management and public health strategies.
Main Methods:
- Population-based surveillance was conducted in British Columbia, Canada.
- Data was collected from April 1, 2010, to March 30, 2020.
- Incidence, risk factors, and case fatality were analyzed for MPP BSI.
Main Results:
- The annual incidence of MPP BSI was 3.4 per 100,000 residents, with Proteus mirabilis being the most common species.
- Community-onset BSIs were predominant (92%), with genitourinary focus most common for P. mirabilis.
- Comorbidities like HIV, dementia, cancer, stroke, and diabetes significantly increased the risk of MPP BSI.
Conclusions:
- The epidemiology of MPP group BSIs varies significantly by species.
- Proteus mirabilis BSIs had a higher case fatality rate compared to Morganella morganii and Providencia species.
- Species-specific understanding is essential for effective management of MPP infections.
