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Epidemiology, aetiology and clinical characteristics of clostridial bacteraemia : a 6-year population-based observational study of 386 patients

Sarasoja, Maaria ; Nilson, Bo LU orcid ; Wide, Daniel ; Lindberg, Åsa LU ; Torisson, Gustav LU orcid and Holm, Karin LU (2022) In European Journal of Clinical Microbiology and Infectious Diseases 41(11). p.1305-1314
Abstract

The objective of this study is to provide a population-based clinical, epidemiological and microbiological overview of clostridial bacteraemia. All cases of bacteraemia in the Skåne Region between 2014 and 2019 with a species currently belonging to the Clostridium genus were identified in the regional clinical microbiology database. Clinical data were retrieved by medical chart-review. A total of 386 unique episodes of clostridial bacteraemia were found resulting in an incidence rate of 4.9/100.000 person-years. The median age was 76 with 56% males. The incidence rate ratio was 34.3 for those aged 80 + vs 0–59. The minimum inhibitory concentrations varied between species but were universally low for metronidazole and carbapenems.... (More)

The objective of this study is to provide a population-based clinical, epidemiological and microbiological overview of clostridial bacteraemia. All cases of bacteraemia in the Skåne Region between 2014 and 2019 with a species currently belonging to the Clostridium genus were identified in the regional clinical microbiology database. Clinical data were retrieved by medical chart-review. A total of 386 unique episodes of clostridial bacteraemia were found resulting in an incidence rate of 4.9/100.000 person-years. The median age was 76 with 56% males. The incidence rate ratio was 34.3 for those aged 80 + vs 0–59. The minimum inhibitory concentrations varied between species but were universally low for metronidazole and carbapenems. Malignancy was the most common co-morbidity, in 47% of patients and most pronounced for C. septicum. Criteria for sepsis and septic shock were met in 69% and 17%, respectively. The 28-day mortality was 26%. High age, absence of fever, high C-reactive protein and high SOFA-score were all significantly associated with mortality. We present the highest incidence rate of clostridial bacteraemia to date. Clostridial bacteraemia is a severe condition with acute onset, affecting elderly with co-morbidities, most pronounced malignancies. Mortality is related to acute manifestations rather than to background factors.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antibiotic susceptibility, Bacteraemia, Blood stream infection, Clostridium, Incidence, Sepsis
in
European Journal of Clinical Microbiology and Infectious Diseases
volume
41
issue
11
pages
10 pages
publisher
Springer
external identifiers
  • pmid:36136283
  • scopus:85138551012
ISSN
0934-9723
DOI
10.1007/s10096-022-04491-8
language
English
LU publication?
yes
id
c4dc45b9-12b3-4a33-ab7b-630f8e0e6fbd
date added to LUP
2022-12-20 12:24:30
date last changed
2025-03-22 04:10:09
@article{c4dc45b9-12b3-4a33-ab7b-630f8e0e6fbd,
  abstract     = {{<p>The objective of this study is to provide a population-based clinical, epidemiological and microbiological overview of clostridial bacteraemia. All cases of bacteraemia in the Skåne Region between 2014 and 2019 with a species currently belonging to the Clostridium genus were identified in the regional clinical microbiology database. Clinical data were retrieved by medical chart-review. A total of 386 unique episodes of clostridial bacteraemia were found resulting in an incidence rate of 4.9/100.000 person-years. The median age was 76 with 56% males. The incidence rate ratio was 34.3 for those aged 80 + vs 0–59. The minimum inhibitory concentrations varied between species but were universally low for metronidazole and carbapenems. Malignancy was the most common co-morbidity, in 47% of patients and most pronounced for C. septicum. Criteria for sepsis and septic shock were met in 69% and 17%, respectively. The 28-day mortality was 26%. High age, absence of fever, high C-reactive protein and high SOFA-score were all significantly associated with mortality. We present the highest incidence rate of clostridial bacteraemia to date. Clostridial bacteraemia is a severe condition with acute onset, affecting elderly with co-morbidities, most pronounced malignancies. Mortality is related to acute manifestations rather than to background factors.</p>}},
  author       = {{Sarasoja, Maaria and Nilson, Bo and Wide, Daniel and Lindberg, Åsa and Torisson, Gustav and Holm, Karin}},
  issn         = {{0934-9723}},
  keywords     = {{Antibiotic susceptibility; Bacteraemia; Blood stream infection; Clostridium; Incidence; Sepsis}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1305--1314}},
  publisher    = {{Springer}},
  series       = {{European Journal of Clinical Microbiology and Infectious Diseases}},
  title        = {{Epidemiology, aetiology and clinical characteristics of clostridial bacteraemia : a 6-year population-based observational study of 386 patients}},
  url          = {{http://dx.doi.org/10.1007/s10096-022-04491-8}},
  doi          = {{10.1007/s10096-022-04491-8}},
  volume       = {{41}},
  year         = {{2022}},
}