Population-Based Study of Bloodstream Infection Incidence and Mortality Rates, Finland, 2004-2018

We evaluated the incidence, outcomes, and causative agents of bloodstream infections (BSI) in Finland during 2004-2018 by using data from the national registries. We identified a total of 173,715 BSIs; annual incidence increased from 150 to 309 cases/100,000 population. BSI incidence rose most sharply among persons >= 80 years of age. The 1-month case-fatality rate decreased from 13.0% to 12.6%, but the 1-month all-cause mortality rate rose from 20 to 39 deaths/100,000 population. BSIs caused by Escherichia coli increased from 26% to 30% of all BSIs. BSIs caused by multidrug-resistant microbes rose from 0.4% to 2.8%, mostly caused by extended-spectrum beta-lactamase-producing E. coli. We observed an increase in community-acquired BSIs, from 67% to 78%. The proportion of patients with severe underlying conditions rose from 14% to 23%. Additional public health and healthcare prevention efforts are needed to curb the increasing trend in community-acquired BSIs and antimicrobial drug-resistant E. coli.

Automated summary

This study evaluated the incidence, outcomes, and causative agents of bloodstream infections in Finland from 2004 to 2018. The incidence of BSI increased annually, especially among those aged 80 years and older. While the 1-month case-fatality rate decreased, the 1-month all-cause mortality rate rose due to an increase in BSIs caused by multidrug-resistant microbes such as extended-spectrum beta-lactamase-producing E. coli. Additional efforts are needed to address the rising trend of community-acquired BSIs and antimicrobial drug-resistant pathogens.