[Hospital-acquired bacteraemia and fungaemia. A regional study with national implications]

Abstract

Introduction: Bacteraemia and fungaemia are among the most frequent hospital-acquired infections. There are only few population-based studies describing long-term trends of occurrence and mortality, and we therefore present such data from North Jutland County.

Materials and methods: All bacteraemias and fungaemias in North Jutland County were recorded in a database during a 15-year period, 1992 through 2006. The population was 0.5 million and the inhabitants were provided with secondary and tertiary care from public hospitals in the county.

Results: A total of 14,977 cases were recorded, 12,275 of which were incident cases. 5,843 (39.0%) were hospital-acquired, 6,576 (43.9%) were community-acquired, and 2,471 (16.5%) were health-care related. The origin was unknown in 86 (0.6%) cases. The numbers of hospital-acquired cases increased 15% during the study period. A number of microorganisms contributed to this rise and the relative increase was largest for Pseudomonas aeruginosa, enterococci and yeasts. In 2005 the rate of hospital-acquired cases was 7.0 (95% confidence interval 6,4-7,8) per 1000 patients and 8.9 (8,1-9,8) per 10,000 hospital days. Overall 30-day mortality was 27.1% (25.8-28.4%) but there was considerable variation among specialities: medicine 30.7% (28.6-33.0%), surgery 19.2% (17.4-21.1%), intensive care 39.9% (36.5-43.4%) and paediatrics 13.1% (8.7-18.7%).

Conclusion: The rates of hospital-acquired bacteraemia and fungaemia increased during most of the study period. Mortality remains high and access to precise and detailed data should promote studies of risk, prognosis and prevention.