title: Temporal changes in the incidence and 30-day mortality associated with bacteremia in hospitalized patients from 1992 through 2006: a population-based cohort study.
abstract: BACKGROUND
  Little is known about temporal trends in the incidence and mortality associated with bacteremia in the general population.
  
  
  METHODS
  We conducted a population-based cohort study in Northern Denmark to examine changes in bacteremia occurrence and 30-day mortality from 1992 through 2006. All patients who received a diagnosis of bacteremia were identified in a population-based bacteremia database and followed up for mortality through the Danish Civil Registry System. We determined the overall annual age- and sex-standardized rates of bacteremia episodes, the incidence of first-time episodes, and the adjusted 30-day mortality by place of acquisition and study period.
  
  
  RESULTS
  We identified 14,303 bacteremia episodes, 11,703 (81.8%) of which were incident. The age- and sex-standardized overall rate of bacteremia increased by 68% from 1992 through 2006, and the incidence increased by 46% (from 114 to 166 episodes per 100,000 person-years). Community-acquired and nosocomial bacteremia incidence rates peaked at 92.1 and 77.2 episodes per 100,000 person-years in 2004 and 2002, respectively, whereas the incidence of health care-associated bacteremia increased steadily from 2.9 to 39.8 episodes per 100,000 person-years. Total number of deaths increased from 742 during 1992-1996 to 926 during 2002-2006. The 30-day mortality decreased in patients with community-acquired bacteremia (19.0% during 1992-1996 vs 15.4% during 2002-2006) but remained nearly unchanged for health care-associated (23.4% and 22.0%, respectively) and nosocomial bacteremia (27.9% and 27.7%, respectively).
  
  
  CONCLUSIONS
  The occurrence of bacteremia in Northern Denmark, regardless of the place of acquisition, increased considerably in the past 15 years, and bacteremia was associated with persistently high 30-day mortality. Thus, bacteremia remains a clinical and public health concern.
authors.affiliation: Department of Clinical Microbiology, Aarhus University Hospital, Aalborg, Denmark. mette.soegaard@rn.dk
authors.forename: Mette
authors.initials: M
authors.lastname: Søgaard
authors.forename: Mette
authors.initials: M
authors.lastname: Nørgaard
authors.forename: Claus
authors.initials: C
authors.lastname: Dethlefsen
authors.forename: Henrik Carl
authors.initials: HC
authors.lastname: Schønheyder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000401:mortality* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055815:Young Adult