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

Daniel Z. Uslan, Sarah J. Crane, James M. Steckelberg, Franklin R. Cockerill, Jennifer St. Sauver, Walter R. Wilson, Larry M. Baddour

Research output: Contribution to journalArticle

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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 sexadjusted 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 personyears 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.

Original languageEnglish (US)
Pages (from-to)834-839
Number of pages6
JournalArchives of Internal Medicine
Volume167
Issue number8
DOIs
StatePublished - Apr 23 2007

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Infection
Population
Medical Record Linkage
Incidence
Gram-Positive Cocci
Sex Distribution
Age Distribution
Cross Infection
Microbiology
Bacillus
Staphylococcus aureus
Epidemiology
Cohort Studies
Escherichia coli
Blood Culture

ASJC Scopus subject areas

  • Internal Medicine

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Age- and sex-associated trends in bloodstream infection : A population-based study in Olmsted County, Minnesota. / Uslan, Daniel Z.; Crane, Sarah J.; Steckelberg, James M.; Cockerill, Franklin R.; St. Sauver, Jennifer; Wilson, Walter R.; Baddour, Larry M.

In: Archives of Internal Medicine, Vol. 167, No. 8, 23.04.2007, p. 834-839.

Research output: Contribution to journalArticle

Uslan, Daniel Z. ; Crane, Sarah J. ; Steckelberg, James M. ; Cockerill, Franklin R. ; St. Sauver, Jennifer ; Wilson, Walter R. ; Baddour, Larry M. / Age- and sex-associated trends in bloodstream infection : A population-based study in Olmsted County, Minnesota. In: Archives of Internal Medicine. 2007 ; Vol. 167, No. 8. pp. 834-839.
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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 sexadjusted 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 personyears 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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AU - Crane, Sarah J.

AU - Steckelberg, James M.

AU - Cockerill, Franklin R.

AU - St. Sauver, Jennifer

AU - Wilson, Walter R.

AU - Baddour, Larry M.

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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 sexadjusted 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 personyears 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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