Mortality trends for bacterial septicaemia in the United States (1999-2024): Age, sex disparities and the impact of the COVID-19 pandemic.

Background: Sepsis remains a significant public health challenge, with persistent mortality rates despite advancements in diagnosis and treatment. This study examined mortality trends for bacterial septicaemia in the US between 1999-2024.

Methods: Mortality data were obtained from the National Center for Health Statistics, National Vital Statistics System, Provisional Mortality WONDER Online Database. Bacterial septicaemia-related deaths were identified using ICD-10 codes, and Poisson regression analysis was performed to assess trends across demographics.

Results: Mortality for bacterial septicaemia declined from 1999 to 2012, showing a modest increase until 2019. A sharp rise occurred during the COVID-19 pandemic (2020-2022), with total deaths for bacterial septicaemia increasing by 21.2 % compared to the pre-pandemic period (17.4 % in females and 23.9 % in males). Mortality rates in males were consistently higher than in females throughout the study period. Poisson regression analysis did not reveal statistically significant long-term cumulative or sex-specific trends. Age-stratified analysis showed a sustained decline in mortality over time among children under 15 years, whereas mortality increased in adults in all age groups between 25 and 74 years. Age-stratified analysis excluding the early pandemic years showed a relative decline in mortality for bacterial septicaemia in those aged <1 to 24 years, a relative increase in the 45-74-year age group, and a stable trend in other age categories.

Conclusions: Although cumulative mortality for bacterial septicaemia remained stable in the long term, rising deaths in middle-aged adults and pandemic-related increases highlight the need for reinforced prevention, timely diagnosis and accurate management strategies.