Characteristics, incidence and outcome of polymicrobial bloodstream infections: a nationwide population-based study, Finland, 2004-2018.

IF 3.6 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-09-25 DOI:10.1007/s15010-025-02642-5

Keiju S K Kontula, Kirsi Skogberg, Jukka Ollgren, Asko Järvinen, Outi Lyytikäinen

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引用次数: 0

Abstract

Purpose: Bloodstream infections (BSI) are associated with high mortality. Previous studies have reported worse outcome for polymicrobial than for monomicrobial BSIs. We analyzed patient characteristics and temporal trends of the incidence and outcome of polymicrobial BSIs in Finland during 2004-2018.

Methods: We used data from national registries to identify polymicrobial BSIs during 2004-2018 and to determine origin of infection, patients' comorbidities and death within 30 days. Charlson comorbidity index (CCI) was calculated according to ICD-10 diagnose codes.

Results: In total, 173,715 BSIs were identified; 11,347 (6.5%) were polymicrobial. Compared with monomicrobial BSIs, the proportion of males, healthcare-associated BSIs, and patients with high CCI were greater in polymicrobial BSIs (58.5% vs. 51.5%, 34.7% vs. 28.7%, and 24.9% vs. 21.1%, respectively). Escherichia coli, enterococci, coagulase-negative staphylococci, and Klebsiella sp. were the most common pathogens of polymicrobial BSIs. Anaerobic bacteria were noted in 16.3% of polymicrobial BSIs, compared with 4.3% of monomicrobial BSIs. The annual polymicrobial BSI incidence rose from 9.7 to 21.8/100,000 population during 2004-2018, most sharply among patients aged ≥ 90 years. The 30-day case fatality of polymicrobial BSIs was 20.6%, significantly higher than in monomicrobial BSIs (12.4%), and a decline from 25.2 to 20.8% was observed over time.

Conclusion: Polymicrobial BSI incidence increased twofold during 2004-2018. The case fatality was considerably higher in polymicrobial than in monomicrobial episodes, likely related to patients' older age and more severe comorbidity. Our findings emphasize the need for prompt recognition of patients at risk to guide the choice of empiric treatment.

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多微生物血流感染的特征、发病率和结果：2004-2018年芬兰一项全国性人群研究

目的：血流感染（BSI）与高死亡率相关。先前的研究报道了多微生物性脑损伤的预后比单微生物性脑损伤差。我们分析了2004-2018年芬兰多微生物性脑损伤的患者特征、发病率和预后的时间趋势。方法：我们使用来自国家登记处的数据来识别2004-2018年期间的多微生物性脑损伤，并确定感染来源、患者合并症和30天内的死亡情况。根据ICD-10诊断代码计算Charlson共病指数（CCI）。结果：共鉴定出173,715例bsi；多微生物11347例（6.5%）。与单微生物性脑损伤相比，多微生物性脑损伤中男性、医疗相关脑损伤和高CCI患者的比例更高（分别为58.5%比51.5%、34.7%比28.7%、24.9%比21.1%）。大肠杆菌、肠球菌、凝固酶阴性葡萄球菌和克雷伯氏菌是多微生物性脑损伤最常见的病原体。在16.3%的多微生物BSIs中发现厌氧菌，而在4.3%的单微生物BSIs中发现厌氧菌。2004-2018年间，多微生物BSI的年发病率从9.7 /10万人上升到21.8/10万人，其中年龄≥90岁的患者发病率最高。多微生物性脑损伤的30天病死率为20.6%，显著高于单微生物性脑损伤（12.4%），随着时间的推移，病死率从25.2%下降到20.8%。结论：2004-2018年间，多微生物BSI发病率增加了两倍。多微生物感染的病死率明显高于单微生物感染，这可能与患者年龄较大和更严重的合并症有关。我们的研究结果强调需要及时识别有风险的患者，以指导经验性治疗的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.