Summary
Background
This article provides baseline epidemiological data on Pseudomonas spp. bloodstream infection (BSI) in England for comparison against future findings
from the mandatory surveillance of this infection, beginning April 2017.
Aim
To report trends in incidence, 30-day all-cause mortality and antimicrobial resistance
of Pseudomonas spp. BSI in England between 2009 and 2018.
Methods
Patients and antibiotic susceptibility data were obtained from UK Health Security
Agency's voluntary surveillance database. Mortality information was linked from a
central data repository.
Findings
There were 39,322 Pseudomonas spp. BSIs between 2009 and 2018. Regression analysis found that the incidence rate
was greater by 18.5% (P<0.01) in the summer (June–August) and by 16.2% (P<0.01) in the autumn (September–November), compared with spring (March–May). The 30-day
all-cause case fatality rate (CFR) declined from 32.0% in 2009 to 23.8% in 2018 (P<0.001). In 2018, resistance to the key antibiotic agents were: ciprofloxacin (7.5%),
ceftazidime (6.8%), piperacillin/tazobactam (6.6%), carbapenems (5.5%) and gentamicin
(4.1%). The mortality rate per 100,000 population was greater by 25.7% (P<0.01) in autumn and 23.6% (P<0.01) in winter (December–February).
Conclusion
Despite an overall increase in the number of cases in recent years, the percentage
of patients dying (from all causes) after a Pseudomonas spp. BSI has been declining. However, compared with other prominent healthcare-associated
BSIs, the CFRs are high, and it underscores the need for continued surveillance to
support targeted infection control and prevention strategies, provide further understanding
of patients' risks groups, and perhaps inform antimicrobial practices.
Keywords
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Article info
Publication history
Published online: November 19, 2021
Accepted:
November 15,
2021
Received:
September 14,
2021
Identification
Copyright
Crown Copyright © 2021 Published by Elsevier Ltd on behalf of The Healthcare Infection Society. All rights reserved.
