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Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota.

Abstract

BACKGROUND

Despite increasing concerns about antimicrobial resistance and emerging pathogens among blood culture isolates, contemporary population-based data on the age- and sex-specific incidence of bloodstream infections (BSIs) are limited.

METHODS

Retrospective, population-based, cohort study of all residents of Olmsted County, Minnesota, with a BSI between January 1, 2003, and December 31, 2005. The medical record linkage system of the Rochester Epidemiology Project and microbiology records were used to identify incident cases.

RESULTS

A total of 1051 unique patients with positive blood culture results were identified; 401 (38.2%) were classified as contaminated. Of 650 patients with cultures deemed clinically relevant, the mean +/- SD age was 63.1 +/- 23.1 years, and 52.5% were male. The most common organisms identified were Escherichia coli (in 163 patients with BSIs [25.1%]) and Staphylococcus aureus (in 108 patients with BSIs [16.6%]). Nosocomial BSIs were more common in males than females (23.8% vs 13.9%; P = .002). The age-adjusted incidence rate of BSI was 156 per 100 000 person-years for females and 237 per 100 000 person-years for males (P<.001), with an age- and sex-adjusted rate of 189 per 100 000 person-years. Rates of BSI due to gram-positive cocci were 64 per 100 000 person-years for females and 133 per 100 000 person-years for males (P<.001); gram-negative bacillus BSI rates (85/100 000 person-years for females and 79/100 000 person-years for males) were not significantly different between sexes (P = .79). The rate of S aureus BSI was 23 per 100 000 person-years for females and 46 per 100 000 person-years for males (P = .005).

CONCLUSIONS

There are significant differences in the age and sex distribution of organisms among patients with BSIs. The incidence of BSI increases sharply with increasing age and is significantly higher in males, mainly because of nosocomial organisms, including S aureus.

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  • Authors+Show Affiliations

    ,

    Divisions of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minn, USA. duslan@mednet.ucla.edu

    , , , , ,

    Source

    Archives of internal medicine 167:8 2007 Apr 23 pg 834-9

    MeSH

    Age Factors
    Bacteremia
    Cohort Studies
    Cross Infection
    Escherichia coli Infections
    Female
    Gram-Negative Bacterial Infections
    Humans
    Male
    Middle Aged
    Minnesota
    Retrospective Studies
    Sex Factors
    Staphylococcal Infections

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    17452548

    Citation

    Uslan, Daniel Z., et al. "Age- and Sex-associated Trends in Bloodstream Infection: a Population-based Study in Olmsted County, Minnesota." Archives of Internal Medicine, vol. 167, no. 8, 2007, pp. 834-9.
    Uslan DZ, Crane SJ, Steckelberg JM, et al. Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. Arch Intern Med. 2007;167(8):834-9.
    Uslan, D. Z., Crane, S. J., Steckelberg, J. M., Cockerill, F. R., St Sauver, J. L., Wilson, W. R., & Baddour, L. M. (2007). Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. Archives of Internal Medicine, 167(8), pp. 834-9.
    Uslan DZ, et al. Age- and Sex-associated Trends in Bloodstream Infection: a Population-based Study in Olmsted County, Minnesota. Arch Intern Med. 2007 Apr 23;167(8):834-9. PubMed PMID: 17452548.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. AU - Uslan,Daniel Z, AU - Crane,Sarah J, AU - Steckelberg,James M, AU - Cockerill,Franklin R,3rd AU - St Sauver,Jennifer L, AU - Wilson,Walter R, AU - Baddour,Larry M, PY - 2007/4/25/pubmed PY - 2007/5/18/medline PY - 2007/4/25/entrez SP - 834 EP - 9 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 167 IS - 8 N2 - BACKGROUND: Despite increasing concerns about antimicrobial resistance and emerging pathogens among blood culture isolates, contemporary population-based data on the age- and sex-specific incidence of bloodstream infections (BSIs) are limited. METHODS: Retrospective, population-based, cohort study of all residents of Olmsted County, Minnesota, with a BSI between January 1, 2003, and December 31, 2005. The medical record linkage system of the Rochester Epidemiology Project and microbiology records were used to identify incident cases. RESULTS: A total of 1051 unique patients with positive blood culture results were identified; 401 (38.2%) were classified as contaminated. Of 650 patients with cultures deemed clinically relevant, the mean +/- SD age was 63.1 +/- 23.1 years, and 52.5% were male. The most common organisms identified were Escherichia coli (in 163 patients with BSIs [25.1%]) and Staphylococcus aureus (in 108 patients with BSIs [16.6%]). Nosocomial BSIs were more common in males than females (23.8% vs 13.9%; P = .002). The age-adjusted incidence rate of BSI was 156 per 100 000 person-years for females and 237 per 100 000 person-years for males (P<.001), with an age- and sex-adjusted rate of 189 per 100 000 person-years. Rates of BSI due to gram-positive cocci were 64 per 100 000 person-years for females and 133 per 100 000 person-years for males (P<.001); gram-negative bacillus BSI rates (85/100 000 person-years for females and 79/100 000 person-years for males) were not significantly different between sexes (P = .79). The rate of S aureus BSI was 23 per 100 000 person-years for females and 46 per 100 000 person-years for males (P = .005). CONCLUSIONS: There are significant differences in the age and sex distribution of organisms among patients with BSIs. The incidence of BSI increases sharply with increasing age and is significantly higher in males, mainly because of nosocomial organisms, including S aureus. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/17452548/Age__and_sex_associated_trends_in_bloodstream_infection:_a_population_based_study_in_Olmsted_County_Minnesota_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.167.8.834 DB - PRIME DP - Unbound Medicine ER -