Table 1 Patient characteristics, incidence, acquisition, source of infection, aetiology, clinical features and mortality
Characteristics | Years | ||||||
|---|---|---|---|---|---|---|---|
1991–1995 | 1996–2000 | 2001–2005 | 2006–2010 | 2011–2015 | 2016–2020 | p | |
No episodes | 476 | 676 | 790 | 1175 | 1705 | 1955 | |
Incidence per-100,000 population | 43.8 | 63.5 | 76.1 | 77 | 170.8 | 205.1 | < 0.001 |
Male nº (%) | 264 (55.5) | 404 (59.8) | 462 (58.5) | 727 (61.9) | 1010 (59.2) | 1176 (60.2) | 0.247 |
Age, mean ± SD | 62.1 ± 19.6 | 57.1 ± 23.9 | 63.5 ± 18.9 | 65.5 ± 18.2 | 68.7 ± 16.3 | 70.6 ± 15 | < 0.05 |
McCabe fatal-rapidly fatal | 185 (38.9) | 335 (49.6) | 404 (51.1) | 545 (46.4) | 888 (52.1) | 1209 (61.8) | < 0.001 |
Urinary catheter | 81 (17) | 87 (12.9) | 111 (14.1) | 223 (19) | 286 (16.8) | 296 (15.1) | 0.004 |
Vascular catheter | 176 (37) | 228 (33.4) | 290 (36.7) | 404 (34.4) | 443 (26) | 570 (29.1) | < 0.001 |
Parenteral nutrition | 59 (12.4) | 85 (12.6) | 107 (13.5) | 187 (15.9) | 210 (12.3) | 275 (14.1) | 0.098 |
Mechanical ventilation | 19 (4) | 8 (1.2) | 12 (1.5) | 32 (2.7) | 25 (1.5) | 50 (2.6) | 0.015 |
Previous antimicrobial therapy | 119 (25) | 176 (26) | 232 (29.4) | 332 (28.3) | 424 (24.9) | 492 (25.2) | 0.085 |
Neutropenia | 21 (4.5) | 41 (6.1) | 49 (6.2) | 53 (4.5) | 67 (3.9) | 68 (3.5) | 0.008 |
Injecting drug abuser | 38 (8) | 37 (5.5) | 23 (2.9) | 23 (2) | 8 (0.5) | 18 (0.9) | < 0.001 |
HIV | 31 (6.5) | 43 (6.4) | 33 (4.2) | 20 (1.7) | 22 (1.3) | 23 (1.2) | < 0.001 |
Diabetes mellitus | 128 (26.9) | 124 (18.3) | 193 (24.4) | 291 (24.8) | 448 (26.3) | 562 (28.7) | < 0.001 |
Cancer | 89 (18.7) | 183 (27.1) | 225 (28.5) | 347 (29.6) | 482 (28.3) | 579 (29.6) | < 0.001 |
Inmunosuppressive treatment | 42 (8.8) | 99 (14.6) | 154 (19.5) | 239 (20.3) | 305 (17.9) | 400 (20.5) | < 0.001 |
Surgery | 80 (16.8) | 118 (17.5) | 143 (18.1) | 222 (18.9) | 240 (14.1) | 240 (12.3) | < 0.001 |
Source | |||||||
Unknown | 61 (12.8) | 113 (16.7) | 74 (9.4) | 99 (8.4) | 131 (7.7) | 110 (5.6) | < 0.001 |
Urinary tract | 97 (20.4) | 114 (16.9) | 178 (22.5) | 270 (23) | 511 (30) | 624 (31.9) | < 0.001 |
Vascular catheter | 78 (16.4) | 115 (17) | 150 (19) | 235 (20) | 240 (14.1) | 339 (17.3) | 0.001 |
Respiratory tract | 56 (11.8) | 104 (15.4) | 113 (14.3) | 149 (12.7) | 164 (9.6) | 193 (9.9) | < 0.001 |
Biliary tract | 37 (7.8) | 50 (7.4) | 72 (9.1) | 146 (12.4) | 274 (16.1) | 289 (14.8) | < 0.001 |
Intra-abdominal | 22 (4.6) | 24 (3.6) | 47 (5.9) | 47 (4) | 76 (4.5) | 64 (3.3) | 0.041 |
Endocarditis | 44 (9.2) | 46 (6.8) | 39 (4.9) | 61 (5.2) | 60 (3.5) | 72 (3.7) | < 0.001 |
Skin and soft tissues | 16 (3.4) | 39 (5.8) | 27 (3.4) | 49 (4.2) | 71 (4.2) | 79 (4) | 0.275 |
Osteoarticular | 7 (1.5) | 7 (1) | 14 (1.8) | 14 (1.2) | 24 (1.4) | 24 (1.2) | 0.835 |
Other | 136 (28.6) | 179 (26.5) | 226 (28.6) | 340 (28.9) | 394 (23.1) | 500 (25.6) | 0.004 |
Aetiology | |||||||
Polymicrobial bacteraemia | 29 (6.1) | 54 (8) | 76 (9.6) | 132 (11.2) | 161 (9.4) | 217 (11.1) | 0.009 |
Monomicrobial bacteraemia | 447 (93.9) | 622 (92) | 714 (90.4) | 1043 (88.8) | 1544 (90.6) | 1738 (88.9) | 0.005 |
Gram-negative bacteria | 240 (50.4) | 335 (49.6) | 384 (48.6) | 598 (50.9) | 982 (57.6) | 1114 (57) | < 0.001 |
E. coli | 123 (25.8) | 190 (28.1) | 250 (31.6) | 403 (34.3) | 699 (41) | 736 (37.6) | < 0.001 |
Klebsiella spp. | 14 (2.9) | 22 (3.3) | 37 (4.7) | 50 (4.3) | 94 (5.5) | 115 (5.9) | 0.013 |
Proteus spp. | 21 (4.4) | 12 (1.8) | 19 (2.4) | 25 (2.1) | 37 (2.2) | 53 (2.7) | 0.06 |
Pseudomonas spp. | 13 (2.7) | 11 (1.6) | 17 (2.2) | 34 (2.9) | 39 (2.3) | 52 (2.7) | 0.566 |
Gram-positive bacteria | 201 (42.2) | 291 (43) | 344 (43.5) | 501 (42.6) | 615 (36.1) | 744 (38.1) | < 0.001 |
S. aureus | 66 (13.9) | 77 (11.4) | 88 (11.1) | 115 (9.8) | 148 (8.7) | 148 (7.6) | < 0.001 |
Coagulase-negative staphylococci | 57 (12) | 87 (12.9) | 103 (13) | 180 (15.3) | 190 (11.1) | 261 (13.4) | 0.043 |
Strep. pneumoniae | 23 (4.8) | 59 (8.7) | 73 (9.2) | 88 (7.5) | 80 (4.7) | 94 (4.8) | < 0.001 |
Enterococcus spp. | 16 (3.4) | 21 (3.1) | 20 (2.5) | 31 (2.6) | 58 (3.4) | 82 (4.2) | 0.163 |
Anaerobes | 23 (4.8) | 31 (4.6) | 40 (5.1) | 37 (3.1) | 46 (2.7) | 52 (2.7) | 0.002 |
Candida spp. | 9 (1.9) | 6 (0.9) | 15 (1.9) | 22 (1.9) | 39 (2.3) | 30 (1.5) | 0.269 |
Resistant bacteria | |||||||
Methicillin-resistant S. aureus* | 1/66 (1.5) | 2/77 (2.6) | 12 /88 (13.6) | 13/115 (11.3) | 25/148 (16.9) | 14/148 (9.5) | 0.002 |
ESBL-producing Enterobacteriales# | 2/209 (1) | 4/259 (1.5) | 14/343 (4.1) | 49/525 (9.3) | 107/899 (11.9) | 120/998 (12) | < 0.001 |
Severe sepsis/septic shock | 100 (21) | 116 (17.2) | 140 (17.7) | 220 (18.7 | 380 (22.3) | 371 (19) | 0.017 |
Appropriate EAT | 302 (63.4) | 452 (66.9) | 526 (66.6) | 793 (67.5) | 1276 (74.8) | 1398 (71.5) | < 0.001 |
30-day mortality | 124 (26.1) | 141 (20.9) | 179 (22.7) | 212 (18) | 252 (14.8) | 271 (13.9) | < 0.001 |