P M Martínez Pérez-Crespo1, L E López-Cortés2, P Retamar-Gentil1, J F Lanz García1, D Vinuesa García3, E León4, J M Sánchez Calvo5, F Galán-Sánchez6, C Natera Kindelan7, A Del Arco Jiménez8, A Sánchez-Porto9, C Herrero Rodríguez10, B Becerril Carral11, I M Reche Molina12, J M Reguera Iglesias13, I Pérez Camacho14, M Guzman García15, I López-Hernández1, J Rodríguez-Baño1. 1. Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena/Departamento de Medicina, Universidad de Sevilla/Instituto de Biomedicina de Sevilla, Sevilla, Spain. 2. Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena/Departamento de Medicina, Universidad de Sevilla/Instituto de Biomedicina de Sevilla, Sevilla, Spain. Electronic address: luiselopezcortes@gmail.com. 3. Unidad Gestión Clínica Enfermedades Infecciosas, Hospital Universitario Clínico San Cecilio, Granada, Spain. 4. Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain. 5. Unidad de Gestion Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Jerez de la Frontera, Jerez de la Frontera, Spain. 6. Unidad de Gestión Clínica de Microbiología, Hospital Universitario Puerta del Mar, Cádiz, Spain. 7. Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, Spain. 8. Grupo Enfermedades Infeccisas, Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Spain. 9. Unidad de Enfermedades Infecciosas y Microbiología, Hospital de la Línea de la Concepción, La Línea de la Concepción, Spain. 10. Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología Clínica, Complejo Hospitalario de Jaén, Jaén, Spain. 11. Unidad Clínica de Gestión de Enfermedades Infecciosas y Microbiología del Área Sanitaria del Campo de Gibraltar, Cádiz, Spain. 12. Unidad de Enfermedades Infecciosas, Hospital Universitario Torrecárdenas, Almería, Spain. 13. Servicio de Enfermedades Infecciosas, Hospital Regional Universitario de Málaga, IBIMA Málaga, Málaga, Spain. 14. Unidad de Medicina Tropical, Hospital General de Poniente, El Ejido, Spain. 15. Servicio de Medicina Interna, Hospital San Juan de la Cruz, Úbeda, Spain.
Abstract
OBJECTIVES: During the last decade, some changes in the epidemiology of invasive infections have been reported; however, specific studies with patient-level data are scarce. The aim of this study was to describe and evaluate the epidemiologic changes in bloodstream infections (BSI) during the last decade in Andalucía, Spain. METHODS: Data from two prospective cohorts of BSI in adults with the same methodology performed 10 years apart in 11 hospitals (eight tertiary and three community) in Andalucía, Spain, were compared; the 2006-7 cohort study was performed between October 2006 and March 2007, and the 2016-17 cohort study was performed between October 2016 and March 2017. Population-based incidence rates were calculated and extrapolated for 1 year. Relative risk ratios were calculated between the 2 periods. Multivariate analyses were performed by logistic regression. RESULTS: Overall, 1262 episodes of BSI were included, 563 (44.6%) in 2006-7 and 699 (55.3%) in 2016-17. Multivariate models selected the following changes in patients' features in 2016-17, after controlling for type of acquisition: higher age (odds ratio (OR) = 1.02; 95% confidence interval [CI] 1.01-1.03), lower urinary catheter (OR = 0.37; 95% CI, 0.26-0.48) and lower Pitt score (OR = 0.76; 95% CI, 0.71-0.82). Adjusted estimations considering patients' features and exposure to procedures showed a reduction in coagulase-negative staphylococci (OR = 0.47; 95% CI, 0.32-0.69), and an increase in Proteus spp. (OR = 3.12; 95% CI, 1.18-8.23) and Candida spp. (OR = 3.01; 95% CI, 1.03-8.86). CONCLUSIONS: We found relevant epidemiologic changes in BSI in our area, including rates, frequency of acquisition types, changes in patient's profiles and aetiologic agents.
OBJECTIVES: During the last decade, some changes in the epidemiology of invasive infections have been reported; however, specific studies with patient-level data are scarce. The aim of this study was to describe and evaluate the epidemiologic changes in bloodstream infections (BSI) during the last decade in Andalucía, Spain. METHODS: Data from two prospective cohorts of BSI in adults with the same methodology performed 10 years apart in 11 hospitals (eight tertiary and three community) in Andalucía, Spain, were compared; the 2006-7 cohort study was performed between October 2006 and March 2007, and the 2016-17 cohort study was performed between October 2016 and March 2017. Population-based incidence rates were calculated and extrapolated for 1 year. Relative risk ratios were calculated between the 2 periods. Multivariate analyses were performed by logistic regression. RESULTS: Overall, 1262 episodes of BSI were included, 563 (44.6%) in 2006-7 and 699 (55.3%) in 2016-17. Multivariate models selected the following changes in patients' features in 2016-17, after controlling for type of acquisition: higher age (odds ratio (OR) = 1.02; 95% confidence interval [CI] 1.01-1.03), lower urinary catheter (OR = 0.37; 95% CI, 0.26-0.48) and lower Pitt score (OR = 0.76; 95% CI, 0.71-0.82). Adjusted estimations considering patients' features and exposure to procedures showed a reduction in coagulase-negative staphylococci (OR = 0.47; 95% CI, 0.32-0.69), and an increase in Proteus spp. (OR = 3.12; 95% CI, 1.18-8.23) and Candida spp. (OR = 3.01; 95% CI, 1.03-8.86). CONCLUSIONS: We found relevant epidemiologic changes in BSI in our area, including rates, frequency of acquisition types, changes in patient's profiles and aetiologic agents.
Authors: Marco Mussa; Pedro María Martínez Pérez-Crespo; Luis Eduardo Lopez-Cortes; Pilar Retamar-Gentil; Adrián Sousa-Dominguez; Ane Josune Goikoetxea-Aguirre; José María Reguera-Iglesias; Eva León Jiménez; Isabel Fernández-Natal; Carlos Armiñanzas-Castillo; Lucía Boix-Palop; Jordi Cuquet-Pedragosa; Miguel Ángel Morán Rodríguez; Jonathan Fernandez-Suarez; Alfonso Del Arco-Jiménez; Alfredo Jóver-Saenz; Alberto Bahamonde-Carrasco; Fátima Galan-Sanchez; Juan Manuel Sánchez-Calvo; Alejandro Smithson-Amat; David Vinuesa-García; Antonio Sánchez-Porto; Inmaculada López-Hernández; Jesús Rodríguez-Baño Journal: Microbiol Spectr Date: 2022-06-30