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Abstract

Background

Bloodstream infections (BSI) cause substantial morbidity and mortality.

Aim

We explored the role of causative pathogens and patient characteristics on the outcome of community-acquired (CA) and healthcare-associated (HA) BSI, with particular interest in early death.

Methods

We used national register data to identify all BSI in Finland during 2004–18. We determined the origin of BSI, patients´ underlying comorbidities and deaths within 2 or 30 days from specimen collection. A time-dependent Cox model was applied to evaluate the impact of patient characteristics and causative pathogens on the hazard for death at different time points.

Results

A total of 173,715 BSI were identified; 22,474 (12.9%) were fatal within 30 days and, of these, 6,392 (28.4%) occurred within 2 days (7.9 deaths/100,000 population). The 2-day case fatality rate of HA-BSI was higher than that of CA-BSI (5.4% vs 3.0%). Patients who died within 2 days were older than those alive on day 3 (76 vs 70 years) and had more severe comorbidities. Compared with other BSI, infections leading to death within 2 days were more often polymicrobial (11.8% vs 6.3%) and caused by (6.2% vs 2.0%), fungi (2.9% vs 1.4%) and multidrug-resistant (MDR) pathogens (2.2% vs 1.8%), which were also predictors of death within 2 days in the model.

Conclusions

Overrepresentation of polymicrobial, fungal, and MDR aetiology among BSI leading to early death is challenging concerning the initial antimicrobial treatment. Our findings highlight the need for active prevention and prompt recognition of BSI and appropriate antimicrobial treatment.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2022-09-08
2024-04-16
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.36.2101067
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Early deaths associated with community-acquired and healthcare-associated bloodstream infections: a population-based study, Finland, 2004 to 2018
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Keiju+SK+Kontula&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kontula Keiju SK</a>, <a href="/search?value1=Kirsi+Skogberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Skogberg Kirsi</a>, <a href="/search?value1=Jukka+Ollgren&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ollgren Jukka</a>, <a href="/search?value1=Asko+J%C3%A4rvinen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Järvinen Asko</a>, <a href="/search?value1=Outi+Lyytik%C3%A4inen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lyytikäinen Outi</a></span>. Early deaths associated with community-acquired and healthcare-associated bloodstream infections: a population-based study, Finland, 2004 to 2018. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(36):pii=2101067. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.36.2101067" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.36.2101067</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 02 Nov 2021;&nbsp;&nbsp; <span class="generated">Accepted</span>: 29 Mar 2022 </span> </p>
/content/10.2807/1560-7917.ES.2022.27.36.2101067
/content/10.2807/1560-7917.ES.2022.27.36.2101067
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