Epidemiology of injury-related bloodstream infections in Queensland, Australia: a population-based data linkage study.

Abstract

Bloodstream infections (BSIs) are an important complication among injured patients, yet existing studies have focused on selected populations or specific settings, limiting the generalisability of the findings. In this study, we conducted a population-based study to examine the incidence, demographic and clinical variation of injury-related BSIs. The study population consisted of all residents of Queensland, Australia, who developed an injury-related BSI identified between 1 January 2000 and 31 December 2019. The linked data used for this study consisted of three statewide databases of all public and private hospital admissions, public pathology data and deaths. ICD-10 AM codes for injuries (S00-T75 and T79) were used to identify hospitalisations for index injuries. Incidence rates were calculated by age, sex, geographic remoteness and socio-economic status using estimated residential population data and aggregated acute injury hospital episodes. Across 20 years, a total of 3205 injury-related BSI episodes occurred among 3188 individuals. The median age of this cohort was 63 years, with males accounting for 65 % of the population. The overall 30-day case-fatality rate was 13 %. During the study period, age-standardised rates increased from 2.47 to 4.62 per 100,000 population, with males experiencing higher rates than females. Patients from remote areas in Queensland had significantly higher rates compared to those from other regions. Additionally, age-specific rates increased with advancing age. Approximately two-thirds of the injury-related BSI episodes were hospital-onset. The most commonly identified pathogens among these patients were Staphylococcus aureus and Escherichia coli. This world-first population-based study on injury-related BSIs provides a comprehensive understanding of the incidence and variation by demographic and clinical characteristics. Injury-related BSIs differed across subgroups: males, remote area residents and older people had higher rates than females, urban/regional area residents and younger individuals. These findings provide a foundation for further work to target treatment and interventions to minimise the burden of injury-related BSIs.