Zahin Amin-Chowdhury
@acciochoc.bsky.social
42 followers 67 following 12 posts
epidemiologist @UKHSA • MSc Epi @lshtm • excited about all things #infectiousdiseases #vaccines #pneumococcus & now #hcai
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Reposted by Zahin Amin-Chowdhury
andmazzella.bsky.social
Annual epi update on bloodstream infections and C. difficile infections in England.

Continuing worrying trend of increasing rates of most of these infections, especially for community-onset cases
acciochoc.bsky.social
🆕 Our Annual Epidemiological Commentary on 6 key HCAIs was published this week - using England national mandatory surveillance data 🦠.

#hcai #surveillance #epidemiology

Some key highlights ⬇️
Annual epidemiological commentary: Gram-negative, MRSA, MSSA bacteraemia and C. difficile infections, up to and including financial year 2024 to 2025
www.gov.uk
acciochoc.bsky.social
👏 finally appreciation for the huge team effort contributing to this report & surveillance - from the healthcare staff at NHS acute trusts who are submitting the data on regular basis, to the epidemiologists crunching the data & everyone providing input.
acciochoc.bsky.social
📊 Mortality

• 30-day case-fatality rate (CFR) fell or stayed stable (except MSSA ↑ 5.2%).

• 30-day mortality rate rose for most infections (in line with incidence rises).

• Graph ⬇️ with data up to 2022/23 shows CFRs across the infections - P. aeruginosa & MRSA among highest CFRs (23-26%)
acciochoc.bsky.social
More on these health inequalities in this research article by @andmazzella.bsky.social et al.
Health inequalities in incidence of bacteraemias: a national surveillance and data linkage study, England, 2018 to 2022
Background Health inequalities exist globally, but limited data exist on this topic for bacteraemia. Aim In this study we investigated health inequalities surrounding bacteraemia in England, to identify high-risk population groups and areas of intervention. Methods We retrospectively analysed English surveillance data between 2018 and 2022 for Escherichia coli, Klebsiella species, Pseudomonas aeruginosa, and both meticillin-sensitive and resistant Staphylococcus aureus (MSSA, MRSA) bacteraemia. Crude incidence rates stratified by index of multiple deprivation and ethnic groups were calculated; age-adjusted rate ratios were estimated using negative binomial regression models. Results We identified 342,787 bacteraemia cases. Across all pathogens, as the level of deprivation rose, so did the age-adjusted bacteraemia incidence rate ratio. Compared with residents of the 20% least deprived areas of England, residents of the 20% most deprived areas had a 2.68-fold increased bacteraemia rate for MRSA (95% CI: 2.29–3.13) and 1.95-fold for E. coli (95% CI: 1.84–2.05), and 15% higher odds of dying within 30 days of any bacteraemia (95% CI: 1.13–1.19). After age adjustment, the incidence of all bacteraemia was higher in the Asian and Black groups compared with the White group: for MRSA, 79% higher in the Asian (95% CI: 1.51–2.10) and 59% higher in the Black (95% CI: 1.29–1.95) groups. The exception was MSSA, whose incidence was highest in the White group. Conclusion Disproportionately higher age-adjusted incidence of bacteraemia occurred in deprived areas and ethnic minorities. These disparities are likely multifactorial, possibly including socioeconomic, cultural, and systemic risk factors and different burden of comorbidities. Better understanding these factors can enable targeted interventions.
www.eurosurveillance.org
acciochoc.bsky.social
⚖️ Ethnicity & deprivation

• Black & Asian groups show the highest age-standardised incidence for most infections (except CDI → highest remained in White group).

• Deprivation: the most deprived areas had 1.5-3.1x higher age-sex standardised incidence vs least deprived.
acciochoc.bsky.social
Clostridioides difficile infections

⚠️ ↑ ~50% since 2020/21 to 33.3 per 100k – the highest since 2011/12. Driven by both hospital- and community-onset cases.

See more on recent CDI rises in this technical report:
Increase in Clostridioides difficile infections (CDI): current epidemiology, data and investigations – Technical report
www.gov.uk
acciochoc.bsky.social
MSSA bacteraemia

↗️ Year-on-year increases continue following the pandemic dip (similar to E. coli), reaching ↑ 12% (unlike E. coli) pre-pandemic levels at 24.2 per 100k.

Community-onset cases were the main driver.
acciochoc.bsky.social
MRSA bacteraemia

⚠️ Sharp ↑ 29.5% to 1.9 per 100k vs 2018/19. Reaching a 12-year high & biggest annual increase since surveillance began. Both hospital- and community-onset driving the rise.
acciochoc.bsky.social
Pseudomonas aeruginosa bacteraemia

↔️ Incidence has mostly remained steady → 7.8 per 100k in 2024/25.

🏥 Hospital-onset incidence = 4.8 per 100k bed-days.
acciochoc.bsky.social
Klebsiella spp. bacteraemia

↗️ Last year saw the sharpest increase since surveillance began - ↑ 10.3%.

Incidence rose again this year to 23.6 per 100k (+2.9% vs 2023/24).

Largely driven by community-onset infections. While most age-sex groups saw rise, particularly notable among male 75+ years.
acciochoc.bsky.social
E. coli bacteraemia

⤴️ In 2024/25, cases rose 17% since 2020/21 → 76.6 per 100k. This rise follows the COVID-19 pandemic dip and is now back to levels similar to those seen in 2018/19.

Most (81%) remain community-onset.
acciochoc.bsky.social
🆕 Our Annual Epidemiological Commentary on 6 key HCAIs was published this week - using England national mandatory surveillance data 🦠.

#hcai #surveillance #epidemiology

Some key highlights ⬇️
Annual epidemiological commentary: Gram-negative, MRSA, MSSA bacteraemia and C. difficile infections, up to and including financial year 2024 to 2025
www.gov.uk
Reposted by Zahin Amin-Chowdhury
eurosurveillance.org
Does the incidence of common bloodstream infections vary across deprivation level & ethnic groups in England and can differences be quantified?

Read what @andmazzella.bsky.social @acciochoc.bsky.social @cstewartb.bsky.social & @amelia-andrews.bsky.social et al found
⬇️
bit.ly/EUS309bc

#IDSky 😷🦠 ⚕️
Key public health message for the article:

What did you want to address in this study and why?

Socioeconomic inequalities exist across infections. We wanted to assess if the incidence of common bacteraemia varies across deprivation level and ethnic groups in England and to quantify any differences. The aim was to identify high-risk population groups and areas for public health interventions. Between 2018 and 2022, we investigated bacteraemia caused by Escherichia coli, Klebsiella and Pseudomonas aeruginosa bacterial species as well as by meticillin-susceptible and resistant Staphylococcus aureus (MRSA, MSSA).

What have we learnt from this study?

In England, bacteraemia from E. coli, Klebsiella spp., P. aeruginosa and particularly MRSA disproportionately affected people from the Black and Asian ethnic groups, after adjusting for age. In contrast, the White ethnic group had higher incidence of community-onset MSSA bacteraemia. People living in the 20% most deprived areas of England also had higher age-standardised incidence of all bacteraemia (176.7 compared to 91.7 per 100,000 population per year in the 20% least deprived areas), and especially MRSA bacteraemia.

What are the implications of your findings for public health?

Public health agencies and health research organisations should consider stratifying their analyses by ethnicity and deprivation to identify and quantify health inequalities. Further studies including qualitative research is required to identify the root causes of these concerning inequalities in the incidence of bacteraemia caused by different pathogens, so that adapted measures can be designed to mitigate them.
Reposted by Zahin Amin-Chowdhury
andmazzella.bsky.social
The big question is: why do we see these sad inequalities?

Difficult to say: complex intersection of factors.

People living in more deprived areas and certain ethnic minorities tend to be more affected by:
💔 predisposing comorbidities
💸 poverty
🏫 low educational attainment
⚕️barriers to healthcare
Reposted by Zahin Amin-Chowdhury
aetiology.bsky.social
Featuring quotes by @greyson.bsky.social & @formerantivax.bsky.social.

Note the importance of lack of judgement here. If you're going to interact w/folks who haven't vaccinated their kids, being assholes to them isn't a great strategy. You don't know their reasoning. /1
Reposted by Zahin Amin-Chowdhury
ipcpartners.bsky.social
We’re really excited to be joined by Dr Issy Centeleghe for IPC Journal Club on Weds 26th February on “Pulling the plug on the sink drain”. Register here: events.teams.microsoft.com/event/8443a2...
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Reposted by Zahin Amin-Chowdhury
acciochoc.bsky.social
Hope your 3 o’clock meeting didn’t push you over the edge 🙃