Bloodstream Infection Incidence Surveillance

This retrospective study used data from a microbiology database to describe BSI incidence from 1 January 2006 to 31 December 2019 in Skåne, southern Sweden, a region with ca 1.4 million inhabitants, see Supplementary material S1 for a description of geography and healthcare in the Skåne region. There is only one database for microbiological diagnostics in the region, which is at the Department of Clinical Microbiology in Lund. During the study period, local routine stated that two sets of blood cultures should be drawn from two separate venepunctures upon suspecting BSI. In the Skåne region, blood cultures are exclusively taken at hospitals providing secondary and tertiary healthcare, at emergency departments, inpatient wards or (rarely) in hospital-based outpatient care. At emergency departments, a nurse may obtain initial blood samples, including blood cultures, if suspecting BSI during triage. Whether the cultures are to be sent for analysis or not is then decided by the treating physician. The BacT/ALERT blood culture system (bioMérieux, Inc., Marcy-l’Étoile, France) was used in the Skåne region until December 2014, when it was replaced by the BACTEC FX (BectonDickinson, Franklin Lakes, United States). Susceptibility testing was performed by disk diffusion according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards [11 ].