Table 1.
Demographics and comorbidities for indigenous and non-indigenous BSI patients 2003–2007
| Indigenous (n=558) | Non-indigenous (n=55) | p Value for difference | |
|---|---|---|---|
| Age (years) (±SD) | 44.7±15.2 | 57.5±21.1 | <0.001 |
| Gender (M/F) (%) | 234/324 (42/58) | 31/23 (57/43) | 0.03 |
| Residence | |||
| Urban | 89 (16.0) | 55 (100.0) | |
| Town camp | 136 (24.4) | 0 (0.0) | |
| Remote community | 333 (59.7) | 0 (0.0) | <0.001 |
| Comorbidities* | |||
| Diabetes | 247 (44.3) | 11 (20.0) | <0.001 |
| Harmful alcohol consumption | 205 (37.0) | 7 (12.7) | <0.001 |
| Chronic kidney disease | |||
| Stages 3–4 | 34 (6.1) | 5 (9.1) | 0.39 |
| Stage 5 | 83 (14.9) | 3 (5.5) | 0.06 |
| Chronic liver disease† | 53 (9.6) | 6 (10.9) | 0.74 |
| Bronchiectasis | 27 (4.8) | 0 | 0.10 |
| Congestive cardiac failure | 15 (2.7) | 3 (5.5) | 0.25 |
| Ischaemic heart disease | 9 (1.6) | 7 (15.2) | <0.001 |
| Valvular heart disease | 27 (4.8) | 3 (5.5) | 0.84 |
| Rheumatic heart disease | 12 (2.0) | 0 (0.0) | 0.27 |
| Palliative care | 10 (1.8) | 5 (9.1) | 0.001 |
| Malignancy | 13 (2.3) | 11 (20.0) | <0.001 |
| IVDU | 0 (0.0) | 3 (5.5) | 0.001 |
| Community acquired | 510 (91.6) | 49 (90.7) | 0.84 |
| Primary focus of BSI | |||
| No focus | 250 (44.8) | 20 (36.4) | 0.37 |
| Pneumonia‡ | 110 (19.7) | 6 (10.9) | 0.08 |
| Skin abscess | 66 (11.8) | 5 (9.1) | 0.65 |
| Pyelonephritis§ | 63 (11.3) | 5 (9.1) | 0.56 |
| Other | 53 (9.5) | 18 (32.7) | <0.001 |
| Enteritis | 15 (2.7) | 1 (1.8) | 0.71 |
| Bone/joint | 1 (0.2) | 0.0 (0.0) | 0.61 |
| Additional infections¶ | |||
| Acute bacterial infections | 69 (12.4) | 2 (3.6) | 0.05 |
| Pneumonia | 18 (3.2) | 0 (0.0) | 0.39 |
| Urinary tract infection | 20 (3.6) | 1 (1.8) | 0.49 |
| Skin infection | 27 (4.8) | 1 (1.8) | 0.31 |
| Enteritis | 4 (0.7) | 0 | 0.53 |
| Chronic viral infections | |||
| HTLV-1** | 137 (45.2) | 0 (0.0) | <0.001 |
| Hepatitis B virus** | |||
| HBsAg | 49 (12.9) | 1 (6.7) | 0.70 |
| Anti-HBc | 193 (62.5) | 3 (27.3) | <0.001 |
| Parasites | |||
| Strongyloidiasis** | 78 (36.1) | 0 (0.0) | 0.001 |
| Scabies | 20 (4.0) | 0 (0.0) | 0.24 |
| Mortality | |||
| 28 days | 62 (11.1) | 7 (12.7) | 0.72 |
| All deaths | 145 (26.0) | 15 (27.3) | 0.84 |
| Age of death (years) | 47±15 | 68±21 | <0.001 |
| Major BSI pathogens†† | 1029 | 110 | |
| Enterobacteriaceae | 370 (36.0) | 38 (34.5) | 0.56 |
| Escherichia coli | 246 (66.5) | 28 (73.7) | 0.37 |
| Klebsiella pneumoniae | 57 (15.4) | 2 (5.3) | 0.09 |
| Staphylococcus aureus | 191 (18.6) | 20 (18.2) | 0.83 |
| MRSA | 53 (27.8) | 1 (5.0) | <0.001 |
| Streptococcus pneumoniae | 136 (13.2) | 8 (5.9) | <0.001 |
| Streptococcus pyogenes | 68 (6.6) | 8 (7.3) | 0.42 |
| Haemophilus influenza | 22 (2.14) | 0 | 0.14 |
| Enteric pathogens‡‡ | 29 (2.81) | 1 (0.91) | 0.27 |
*Comorbidities determined from ICD-10 AM discharge morbidity codes.
†Chronic liver disease attributed to alcohol (Indigenous, 43; non-Indigenous, 5), chronic hepatitis B (Indigenous, 10; non-Indigenous, 0) and chronic hepatitis C (Indigenous, 0; non-Indigenous, 3).
‡Chest X-rays performed for 457 Indigenous patients. Respiratory cultures performed for 150 Indigenous patients.
§Urine cultures performed for 310 Indigenous patients.
¶Pathogens identified in addition to those isolated from blood cultures. Pneumonia, urinary tract, skin and enteritis expressed as a proportion of the total number of acute bacterial infections.
**Indigenous patients tested: HTLV-1, 309; HBsAg, 388; HBcAb, 309; Strongyloides stercoralis serology, 235. Non-Indigenous patients tested: HTLV-1, 4; HBsAg, 16; HBcAb, 11; Strongyloides stercoralis serology, 4. Denominators exclude six Indigenous patients with indeterminate HTLV-1 western blot results and 19 Indigenous patients with borderline Strongyloides serology whose infective status could not be determined.
††Major BSI pathogens for all recorded episodes 2001–2007. E coli and K pneumoniae expressed as a proportion of the Enterobacteriaceae and MRSA expressed as a proportion of all S aureus isolates.
‡‡Includes Salmonella spp., Shigella spp., Campylobacter spp.
BSI, bloodstream infection; HBsAg, hepatitis B surface antigen positive; anti-HBc, Hepatitis B core antibody positive; HTLV-1, human T-lymphotropic virus type 1; ICD, International Classification of Diseases; IVDU, intravenous drug use; MRSA, methicillin-resistant Staphylococcus aureus.