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


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%).


CONCLUSIONS
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.
Schønheyder
Henrik C
HC
Aalborg Sygehus Syd, Klinisk Mikrobiologisk Afdeling, Aalborg. hcs@rn.dk
Søgaard
Mette
M
D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control; D003718:Denmark / Q000453:epidemiology; D016469:Fungemia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D017053:Infection Control; D011379:Prognosis