Epidemiology of Escherichia coli bacteraemia in England: results of an enhanced sentinel surveillance programme

Background: Escherichia coli causes over one third of the bacteraemia cases in England each year, and the incidence of these infections is increasing. Aim: To determine the underlying risk factors associated with E. coli bacteraemia. Methods: A three month enhanced sentinel surveillance study involving 35 National Health Service hospitals was undertaken in the winter of 2012/13 to collect risk factor information and further details on the underlying source of infection to augment data already collected by the English national surveillance programme. Antimicrobial susceptibility results for E. coli isolated from blood and urine were also collected. Findings: A total of 1,731 cases of E. coli bacteraemia were included. The urogenital tract was the most commonly reported source of infection (51.2% of cases) with prior treatment for a urinary tract infection being the largest independent effect associated with this infection source. Half of all patients had prior healthcare exposure in the month prior to the bacteraemia with antimicrobial therapy and urinary catheterisation being reported in one third and one fifth of these patients. Prior healthcare exposure was associated with a higher proportion of antibiotic non-susceptibility in the blood culture isolates (P=0.001). Conclusion: Analysis of risk factors suggests potential community and hospital-related interventions particularly better use of urinary catheters and improved antibiotic management of urinary tract infections. As part of the latter strategy, antibiotic resistance profiles need to be closely monitored to ensure treatment guidelines are up to date to limit inappropriate empiric therapy

Research data supporting "Excess Mortality Attributable to Clostridium difficile and Risk Factors for Infection in an Historic Cohort of Hospitalised Patients Followed up in the United Kingdom Death Register"

Data set survival analysis Data set Risk factor analysis Protocol Clinical notes data abstraction Questionnaire 1 Death certificate data abstraction Questionnaire 2 Ethical approval Cambridgeshire Reesearch ethics Committee Ethical approval National Information Governance Board Study set up Medical Resarch Information Service NHS Information Centre Approval Research and Development Office Cambridge Univerity Hospitals NHS Trust Information for service user patients on the study Survey of patent users opinion questionnaire Results of patient user opinion surveyThis research data supports “Excess Mortality Attributable to Clostridium difficile and Risk Factors for Infection in an Historic Cohort of Hospitalised Patients Followed up in the United Kingdom Death Register” which has been published in “PLOSOne”.This work was supported by the Public Health England

Kaplan-Meier survival estimates of non-cases and <i>Clostridium difficile</i> cases.

<p>Kaplan-Meier survival estimates of non-cases and <i>Clostridium difficile</i> cases.</p

Single variable risk factor analysis.

<p>Single variable risk factor analysis.</p

Follow-up distributions for cases and non-cases (years).

<p>Follow-up distributions for cases and non-cases (years).</p

Hazard Ratio for cases compared to non-cases unadjusted and adjusted for variables shown.

<p>Hazard Ratio for cases compared to non-cases unadjusted and adjusted for variables shown.</p