Increased rates of hospital-onset Staphylococcus aureus bacteraemia in National Health Service acute trusts in England between June 2020 and March 2021: a national surveillance review.

A large increase in hospital-onset and intensive-care-unit-onset Staphylococcus aureus bacteraemia rates in English acute trusts was observed between 2020 and 2021, coinciding with reported increases in coronavirus disease (COVID-19) cases and associated hospitalizations. Many of these S. aureus bacteraemia cases were defined as co-/secondary infections to COVID-19. Over the same period, increases in the percentage of ventilator-associated pneumonia-related bacteraemia were also found. The COVID-19 pandemic appears to have contributed to the increase in hospital-onset S. aureus bacteraemia in England; further studies are needed to better understand the impacts on patient outcomes.

Trends in rates of incidence, fatality and antimicrobial resistance among isolates of Pseudomonas spp. causing bloodstream infections in England between 2009 and 2018: results from a national voluntary surveillance scheme.

BACKGROUND: This article provides baseline epidemiological data on Pseudomonas spp. bloodstream infection (BSI) in England for comparison against future findings from the mandatory surveillance of this infection, beginning April 2017. AIM: To report trends in incidence, 30-day all-cause mortality and antimicrobial resistance of Pseudomonas spp. BSI in England between 2009 and 2018. METHODS: Patients and antibiotic susceptibility data were obtained from UK Health Security Agency's voluntary surveillance database. Mortality information was linked from a central data repository. FINDINGS: There were 39,322 Pseudomonas spp. BSIs between 2009 and 2018. Regression analysis found that the incidence rate was greater by 18.5% (P<0.01) in the summer (June-August) and by 16.2% (P<0.01) in the autumn (September-November), compared with spring (March-May). The 30-day all-cause case fatality rate (CFR) declined from 32.0% in 2009 to 23.8% in 2018 (P<0.001). In 2018, resistance to the key antibiotic agents were: ciprofloxacin (7.5%), ceftazidime (6.8%), piperacillin/tazobactam (6.6%), carbapenems (5.5%) and gentamicin (4.1%). The mortality rate per 100,000 population was greater by 25.7% (P<0.01) in autumn and 23.6% (P<0.01) in winter (December-February). CONCLUSION: Despite an overall increase in the number of cases in recent years, the percentage of patients dying (from all causes) after a Pseudomonas spp. BSI has been declining. However, compared with other prominent healthcare-associated BSIs, the CFRs are high, and it underscores the need for continued surveillance to support targeted infection control and prevention strategies, provide further understanding of patients' risks groups, and perhaps inform antimicrobial practices.

Rising rates of hospital-onset Klebsiella spp. and Pseudomonas aeruginosa bacteraemia in NHS acute trusts in England: a review of national surveillance data, August 2020-February 2021.

Increases in hospital-onset Klebsiella spp. and Pseudomonas aeruginosa bacteraemia rates in England were observed between August 2020 and February 2021 to the highest levels recorded since the start of mandatory surveillance in April 2017. Cases were extracted from England's mandatory surveillance database for key Gram-negative bloodstream infections. Incidence rates for hospital-onset bacteraemia cases increased from 8.9 (N=255) to 14.9 (N=394) per 100,000 bed-days for Klebsiella spp. [incidence rate ratio (IRR) 1.7, P<0.001], and from 4.9 (N=139) to 6.2 (N=164) per 100,000 bed-days for P. aeruginosa (IRR 1.3, P<0.001) (August 2020-February 2021). These incidence rates were higher than the average rates observed during the same period in the previous 3 years. These trends coincided with an increase in the percentage of hospital-onset bacteraemia cases that were also positive for severe acute respiratory syndrome coronavirus-2.

Estimating the incidence and 30-day all-cause mortality rate of Escherichia coli bacteraemia in England by 2020/21.

Escherichia coli bacteraemia rates have been increasing in England. Using the national mandatory surveillance data for E. coli bacteraemia from 2012/13 to 2016/17, we aimed to estimate the incidence of E. coli bacteraemia and 30-day all-cause case fatality rate (CFR) by 2020/21 in the absence of new interventions to reduce infection rates. After controlling for age, sex, and hospital versus community-onset of infection, it is estimated that the incidence of E. coli bacteraemia will be 90.5 (95% PI: 89.8-91.3) per 100,000 population (N = 50,663), with an associated CFR of 11.5 (95% PI: 11.2-11.8) per 100,000 population (N = 6554), by 2020/21.