title: Trends among pathogens reported as causing bacteraemia in England, 2004-2008.
abstract: The Health Protection Agency in England operates a voluntary surveillance system that collects data on bacteraemias reported by over 90% of laboratories in England. Trends in causative microorganisms reported between 2004 and 2008 were analyzed using a generalized linear model with a log link function for Poisson distribution. In 2008, 101,276 episodes of bacteraemia were reported; a rate of 189 per 100,000 population. More than one-half occurred in those aged over 65 years and males. The most common organisms reported were Escherichia coli (23%), coagulase-negative staphylococci (CNS) (16.9%) and Staphylococcus aureus (11.4%). Between 2004 and 2008, E. coli bacteraemia increased by 33% (p < 0.001); the species now accounts for more than 30% of bacteraemia in those aged over 75 years. There also were significant increases in bacteraemia caused by other Gram-negative pathogens and marked seasonal variation. Bacteraemia caused by S. aureus increased until 2005, with a decline after 2006 (p < 0.001) entirely due to methicillin-resistant strains. CNS bacteraemia have declined significantly since 2007. The renewed dominance of Gram-negative pathogens as major causes of bacteraemia in England is of particular concern because they are associated with a high morbidity and increasing resistance to antibiotics. Further investigation of the underlying causes and prevention strategies is a public health priority. Recent declines in methicillin-resistant S. aureus bacteraemia have not been reflected in other pathogens, including methicillin-susceptible S. aureus.
authors.affiliation: Health Protection Agency, Centre for Infections, London, UK. jennie.wilson@imperial.nhs.uk
authors.forename: J
authors.initials: J
authors.lastname: Wilson
authors.forename: S
authors.initials: S
authors.lastname: Elgohari
authors.forename: D M
authors.initials: DM
authors.lastname: Livermore
authors.forename: B
authors.initials: B
authors.lastname: Cookson
authors.forename: A
authors.initials: A
authors.lastname: Johnson
authors.forename: T
authors.initials: T
authors.lastname: Lamagni
authors.forename: A
authors.initials: A
authors.lastname: Chronias
authors.forename: E
authors.initials: E
authors.lastname: Sheridan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D055815:Young Adult