Population-based study of Morganella-Proteus-Providencia group bloodstream infections

Morganella morganii bloodstream infection affects the elderly in close contact with health care

Objectives

We aimed to fill the gaps of knowledge concerning incidence rates and temporal trend, clinical features and risk factors for death for Morganella morganii bloodstream infections (BSIs) in south Sweden.

Methods

This was an observational, population-based study including all patients with at least one blood culture positive for M. morganii between 2013 and 2023 in Skåne, south Sweden.

Results

A total of 211 episodes of M. morganii BSI in 201 patients were registered during the study period. A urinary tract-focused BSI was associated with a reduced risk of 90-day mortality (P = 0.0029), whereas a primary BSI was associated with 90-day mortality (P = 0.0112). A multivariate analysis including age, gender, Charlson comorbidity index (CCI), and immunosuppression revealed that higher CCI (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.07-1.47, P = 0.0059) and immunosuppression (OR 3.26, 95% CI 1.45-7.47, P = 0.0045) was independently associated with all-cause mortality.

Conclusions

M. morganii BSI is a disease among the elderly that most often acquired in individuals with comorbidities that are in close contact with health care. A urinary tract focus was associated with reduced risk of 90-day mortality, and higher CCI and immunosuppression were associated with 90-day all-cause mortality in a multivariate analysis.

Proteus species bloodstream infections: Comparative epidemiology of three species

BACKGROUND

Although Proteus species are occasional causes of serious infections, their epidemiology has not been well defined. The objective was to describe the overall and species-specific occurrence and determinants of Proteus species bloodstream infection (BSI) in a large Australian population.

METHODS

All Queensland residents with Proteus species BSI identified within the publicly funded healthcare system between 2000 and 2019 were included.

RESULTS

A total of 2,143 incident episodes of Proteus species BSI were identified among 2,079 Queensland residents. The prevalence of comorbid illness differed with higher Charlson comorbidity scores observed with P. penneri and P. vulgaris, and higher prevalence of liver disease with P. penneri, higher comorbid cancer with P. vulgaris, and lower diabetes and renal disease prevalence with P. mirabilis BSIs.

CONCLUSION

This study provides novel information on the epidemiology of Proteus species BSI.