Septicaemia, E. coli bacteraemia, epidemiology, risk factors, health protection, public health
Objectives:
Risk factors for all-cause mortality (ACM) within 30 days of developing E. coli bacteraemia (ECB) in Wales, a population based prospective cohort.
Methods:
Consecutive ECB cases were collected over three months (Quarter 2, 2014). A web-based questionnaire captured potential risk factor data identified by structured literature review from laboratory, secondary and primary
care data; collected by laboratory, infection prevention and control, and health protection teams- collaborating with general practices/ care homes. The dataset was linked to; routine microbiological data to obtain isolate
antimicrobial sensitivity (AMR) profiles; the Welsh Demographic Service to obtain date of death. Risk factor analysis is underway.
Results:
First episodes of ECB in Welsh residents were analysed (n=495). 18% (90) of ECB patients died within 30 days of the specimen date for a positive E. coli blood culture. The all-Wales ACM rate was 2.9 per 100,000 population (95% CI; 2.35- 3.59); ranging from 2.0 to 6.1 per 100,000 by Health Board. The ACM rate increased with age; from <1 per 100,000 population in the under 54 year age groups (95% CI; NS) to 40.1 in the over 85 year age group (95% CI; 27.25- 56.93). ACM also varied by case classification; 27% of HOHCAI cases died, 16% of COCAI, 12.5% of COHCAI. 70% of those that died had isolates resistant to at least one antimicrobial group.
Conclusions:
Multidisciplinary data provides a comprehensive risk factor analysis of mortality 30 days post-ECB. This will inform an action plan to target the rise of ECB in Wales.