Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease: a Danish, population-based cohort study

Lise Have Nielsen; Søren Jensen-Fangel; Thomas Benfield; Robert Skov; Bente Jespersen; Anders R Larsen; Lars Østergaard; Henrik Støvring; Henrik Carl Schønheyder; Ole S Søgaard

doi:10.1186/s12879-014-0740-8

Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease: a Danish, population-based cohort study

Lise Have Nielsen, Søren Jensen-Fangel, Thomas Benfield, Robert Skov, Bente Jespersen, Anders R Larsen, Lars Østergaard, Henrik Støvring, Henrik Carl Schønheyder, Ole S Søgaard

Institut for Klinisk Medicin

36 Citationer (Scopus)

Abstract

Background: is a leading cause of bloodstream infections among hemodialysis patients and of exit-site infections among peritoneal dialysis patients. However, the risk and prognosis of bacteremia among end-stage renal disease patients have not been delineated. Methods: In this Danish nationwide, population-based cohort study patients with end-stage renal disease and matched population controls were observed from end-stage renal disease diagnosis/sampling until first episode of bacteremia, death, or end of study period. positive blood cultures, hospitalization, comorbidity, and case fatality were obtained from nationwide microbiological, clinical, and administrative databases. Incidence rates and risk factors were assessed by regression analysis. Results: The incidence rate of bacteremia was very high for end-stage renal disease patients (35.7 per 1,000 person-years; 95% CI, 33.8-37.6) compared to population controls (0.5 per 1,000 person-years; 95% CI, 0.5-0.6), yielding a relative risk of 65.1 (95% CI, 59.6-71.2) which fell to 28.6 (95% CI, 23.3-35.3) after adjustment for sex, age, and comorbidity. After stratification for type of renal replacement therapy, we found the highest incidence rate of bacteremia among hemodialysis patients (46.3 per 1,000 person-years) compared to peritoneal dialysis patients (22.0 per 1,000 person-years) and renal transplant recipients (8.9 per 1,000 person-years). In persons with bacteremia, ninety-day case fatality was 18.2% (95% CI, 16.2%-20.3%) for end-stage renal disease patients and 33.7% (95% CI, 30.3-37.3) for population controls. Conclusions: Patients with end-stage renal disease, and hemodialysis patients in particular, have greatly increased risk of bacteremia compared to population controls. Future challenges will be to develop strategies to reduce bacteremia-related morbidity and death in this high-risk population.

Originalsprog	Engelsk
Artikelnummer	6
Tidsskrift	B M C Infectious Diseases
Vol/bind	15
Sider (fra-til)	1-8
Antal sider	8
ISSN	1471-2334
DOI	https://doi.org/10.1186/s12879-014-0740-8
Status	Udgivet - 17 jan. 2015

Adgang til dokumentet

10.1186/s12879-014-0740-8

Citationsformater

Nielsen, L. H., Jensen-Fangel, S., Benfield, T., Skov, R., Jespersen, B., Larsen, A. R., Østergaard, L., Støvring, H., Schønheyder, H. C., & Søgaard, O. S. (2015). Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease: a Danish, population-based cohort study. B M C Infectious Diseases, 15, 1-8. [6]. https://doi.org/10.1186/s12879-014-0740-8

Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease : a Danish, population-based cohort study. / Nielsen, Lise Have; Jensen-Fangel, Søren; Benfield, Thomas et al.

I: B M C Infectious Diseases, Bind 15, 6, 17.01.2015, s. 1-8.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Nielsen, LH, Jensen-Fangel, S, Benfield, T, Skov, R, Jespersen, B, Larsen, AR, Østergaard, L, Støvring, H, Schønheyder, HC & Søgaard, OS 2015, 'Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease: a Danish, population-based cohort study', B M C Infectious Diseases, bind 15, 6, s. 1-8. https://doi.org/10.1186/s12879-014-0740-8

@article{7ec2cfc44bbc49709468255b6b071915,

title = "Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease: a Danish, population-based cohort study",

abstract = "Background: is a leading cause of bloodstream infections among hemodialysis patients and of exit-site infections among peritoneal dialysis patients. However, the risk and prognosis of bacteremia among end-stage renal disease patients have not been delineated. Methods: In this Danish nationwide, population-based cohort study patients with end-stage renal disease and matched population controls were observed from end-stage renal disease diagnosis/sampling until first episode of bacteremia, death, or end of study period. positive blood cultures, hospitalization, comorbidity, and case fatality were obtained from nationwide microbiological, clinical, and administrative databases. Incidence rates and risk factors were assessed by regression analysis. Results: The incidence rate of bacteremia was very high for end-stage renal disease patients (35.7 per 1,000 person-years; 95% CI, 33.8-37.6) compared to population controls (0.5 per 1,000 person-years; 95% CI, 0.5-0.6), yielding a relative risk of 65.1 (95% CI, 59.6-71.2) which fell to 28.6 (95% CI, 23.3-35.3) after adjustment for sex, age, and comorbidity. After stratification for type of renal replacement therapy, we found the highest incidence rate of bacteremia among hemodialysis patients (46.3 per 1,000 person-years) compared to peritoneal dialysis patients (22.0 per 1,000 person-years) and renal transplant recipients (8.9 per 1,000 person-years). In persons with bacteremia, ninety-day case fatality was 18.2% (95% CI, 16.2%-20.3%) for end-stage renal disease patients and 33.7% (95% CI, 30.3-37.3) for population controls. Conclusions: Patients with end-stage renal disease, and hemodialysis patients in particular, have greatly increased risk of bacteremia compared to population controls. Future challenges will be to develop strategies to reduce bacteremia-related morbidity and death in this high-risk population.",

keywords = "Adult, Aged, Bacteremia, Case-Control Studies, Cohort Studies, Denmark, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Prognosis, Registries, Renal Dialysis, Risk Factors, Staphylococcal Infections, Staphylococcus aureus",

author = "Nielsen, {Lise Have} and S{\o}ren Jensen-Fangel and Thomas Benfield and Robert Skov and Bente Jespersen and Larsen, {Anders R} and Lars {\O}stergaard and Henrik St{\o}vring and Sch{\o}nheyder, {Henrik Carl} and S{\o}gaard, {Ole S}",

year = "2015",

month = jan,

day = "17",

doi = "10.1186/s12879-014-0740-8",

language = "English",

volume = "15",

pages = "1--8",

journal = "B M C Infectious Diseases",

issn = "1471-2334",

publisher = "BioMed Central Ltd.",

}

TY - JOUR

T1 - Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease

T2 - a Danish, population-based cohort study

AU - Nielsen, Lise Have

AU - Jensen-Fangel, Søren

AU - Benfield, Thomas

AU - Skov, Robert

AU - Jespersen, Bente

AU - Larsen, Anders R

AU - Østergaard, Lars

AU - Støvring, Henrik

AU - Schønheyder, Henrik Carl

AU - Søgaard, Ole S

PY - 2015/1/17

Y1 - 2015/1/17

N2 - Background: is a leading cause of bloodstream infections among hemodialysis patients and of exit-site infections among peritoneal dialysis patients. However, the risk and prognosis of bacteremia among end-stage renal disease patients have not been delineated. Methods: In this Danish nationwide, population-based cohort study patients with end-stage renal disease and matched population controls were observed from end-stage renal disease diagnosis/sampling until first episode of bacteremia, death, or end of study period. positive blood cultures, hospitalization, comorbidity, and case fatality were obtained from nationwide microbiological, clinical, and administrative databases. Incidence rates and risk factors were assessed by regression analysis. Results: The incidence rate of bacteremia was very high for end-stage renal disease patients (35.7 per 1,000 person-years; 95% CI, 33.8-37.6) compared to population controls (0.5 per 1,000 person-years; 95% CI, 0.5-0.6), yielding a relative risk of 65.1 (95% CI, 59.6-71.2) which fell to 28.6 (95% CI, 23.3-35.3) after adjustment for sex, age, and comorbidity. After stratification for type of renal replacement therapy, we found the highest incidence rate of bacteremia among hemodialysis patients (46.3 per 1,000 person-years) compared to peritoneal dialysis patients (22.0 per 1,000 person-years) and renal transplant recipients (8.9 per 1,000 person-years). In persons with bacteremia, ninety-day case fatality was 18.2% (95% CI, 16.2%-20.3%) for end-stage renal disease patients and 33.7% (95% CI, 30.3-37.3) for population controls. Conclusions: Patients with end-stage renal disease, and hemodialysis patients in particular, have greatly increased risk of bacteremia compared to population controls. Future challenges will be to develop strategies to reduce bacteremia-related morbidity and death in this high-risk population.

AB - Background: is a leading cause of bloodstream infections among hemodialysis patients and of exit-site infections among peritoneal dialysis patients. However, the risk and prognosis of bacteremia among end-stage renal disease patients have not been delineated. Methods: In this Danish nationwide, population-based cohort study patients with end-stage renal disease and matched population controls were observed from end-stage renal disease diagnosis/sampling until first episode of bacteremia, death, or end of study period. positive blood cultures, hospitalization, comorbidity, and case fatality were obtained from nationwide microbiological, clinical, and administrative databases. Incidence rates and risk factors were assessed by regression analysis. Results: The incidence rate of bacteremia was very high for end-stage renal disease patients (35.7 per 1,000 person-years; 95% CI, 33.8-37.6) compared to population controls (0.5 per 1,000 person-years; 95% CI, 0.5-0.6), yielding a relative risk of 65.1 (95% CI, 59.6-71.2) which fell to 28.6 (95% CI, 23.3-35.3) after adjustment for sex, age, and comorbidity. After stratification for type of renal replacement therapy, we found the highest incidence rate of bacteremia among hemodialysis patients (46.3 per 1,000 person-years) compared to peritoneal dialysis patients (22.0 per 1,000 person-years) and renal transplant recipients (8.9 per 1,000 person-years). In persons with bacteremia, ninety-day case fatality was 18.2% (95% CI, 16.2%-20.3%) for end-stage renal disease patients and 33.7% (95% CI, 30.3-37.3) for population controls. Conclusions: Patients with end-stage renal disease, and hemodialysis patients in particular, have greatly increased risk of bacteremia compared to population controls. Future challenges will be to develop strategies to reduce bacteremia-related morbidity and death in this high-risk population.

KW - Adult

KW - Aged

KW - Bacteremia

KW - Case-Control Studies

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Humans

KW - Kidney Failure, Chronic

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Registries

KW - Renal Dialysis

KW - Risk Factors

KW - Staphylococcal Infections

KW - Staphylococcus aureus

U2 - 10.1186/s12879-014-0740-8

DO - 10.1186/s12879-014-0740-8

M3 - Journal article

C2 - 25566857

SN - 1471-2334

VL - 15

SP - 1

EP - 8

JO - B M C Infectious Diseases

JF - B M C Infectious Diseases

M1 - 6

ER -

Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease: a Danish, population-based cohort study

Abstract

Adgang til dokumentet

Fingeraftryk

Citationsformater