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Evolving insights into the epidemiology of Moraxella species bloodstream infection from two decades of surveillance in Queensland, Australia

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Abstract

The epidemiology of Moraxella species bloodstream infection (BSI) is poorly defined due to their rarity. We sought to determine the incidence, risk factors, and outcomes of Moraxella species BSI in a large Australian population. All Moraxella species BSIs in patients admitted to Queensland (population estimate 5 million) public health facilities between 2000 and 2019 and submitted to Queensland pathology laboratory-based surveillance were included. Clinical and hospitalisation data were matched with laboratory-based surveillance data. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were calculated. In total, 375 incident Moraxella species BSI occurred during 86 million person-years of surveillance, with an annualised age and sex standardised incidence of 4.3 per million residents. Isolates were most commonly identified as M. catarrhalis (n = 128; 34%) and community-associated (n = 225; 60%). Incidence was highest in infants, with increasing age associated with lower incidence rate. Males were at higher risk (incidence 2.9 vs. 2.0 per million, IRR1.4; 95% CI, 1.2–1.8), this was most pronounced at age extremes. Two-thirds of adults and 43% of children with Moraxella BSI had at least one comorbid illness. When compared to infections in adults, children were more likely to have community-associated disease, and a head and neck source focus of infection. The all-cause 30-day case-fatality rate was 4% (15/375) and this was significantly higher among adults (14/191; 7% vs 1/183; 1%; p < 0.001). Our findings demonstrate the low burden of Moraxella species BSI in a state-wide cohort, for which young children have the highest risk.

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Acknowledgements

Thank you to Ms. Rita Nemeth for assistance with manuscript submission.

Author information

Authors and Affiliations

  1. Herston Infectious Diseases Institute, Metro North Health, Herston, QLD, Australia

    Jessica Schults & Claire M. Rickard

  2. School of Nursing, Midwifery and Social Work, The University of Queensland, The University of Queensland Centre for Clinical Research, Building 71/918 RBWH Herston, Brisbane City, QLD, 4029, Australia

    Jessica Schults, Karina Charles & Claire M. Rickard

  3. Queensland University of Technology (QUT), Brisbane, QLD, Australia

    Felicity Edwards & Kevin Laupland

  4. Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, QLD, Australia

    Karina Charles

  5. UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia

    Adam D. Irwin, Patrick N. A. Harris & David L. Paterson

  6. Infection Management and Prevention Service, Queensland Children’s Hospital, Brisbane, QLD, Australia

    Adam D. Irwin

  7. Central Microbiology, Pathology Queensland, Brisbane, QLD, Australia

    Patrick N. A. Harris

  8. ADVANCE-ID, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    David L. Paterson

  9. Intensive Care Unit, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia

    Kevin Laupland

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Contributions

FE, KL conceived the study, gained ethics and governance approvals and designed the statistical analysis plan.

JS, FE, KC, KL completed the data analysis, drafted the first manuscript and reviewed and approved the final manuscript.

Corresponding author

Correspondence to Jessica Schults.

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Royal Brisbane and Women’s Hospital Human Research Ethics Committee (LNR/2020/QRBW/62494).

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Not applicable, deidentified data, ethics and governance approvals obtained.

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The authors declare no competing interests.

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Schults, J., Edwards, F., Charles, K. et al. Evolving insights into the epidemiology of Moraxella species bloodstream infection from two decades of surveillance in Queensland, Australia. Eur J Clin Microbiol Infect Dis 42, 209–216 (2023). https://doi.org/10.1007/s10096-022-04540-2

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