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The effect of migration on the incidence and mortality of bloodstream infection: a Danish register-based cohort study

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@article{1b96ee8d30714b11884d2c0a1e622034,
title = "The effect of migration on the incidence and mortality of bloodstream infection: a Danish register-based cohort study",
abstract = "Objectives: To investigate bloodstream infection (BSI) related to migrant status by comparing the incidence and mortality in migrants with that in non-migrants. Methods: In this register-based cohort study we linked a cohort of migrants and non-migrants with a bacteraemia database covering two regions in Denmark. We included first-time BSI between January 2000 and December 2015 in individuals ≥18 years. Migrants were categorized according to status: refugees or family-reunified migrants. Incidence rate ratio and mortality rate ratio were analysed using Poisson regression. Results: We identified 493 080 non-migrants, of which 3405 had BSI, and 80 740 migrants with 576 cases; of the latter, 40 222 were family-reunified migrants with 226 cases and 40 518 were refugees with 350 cases. Refugees had a higher risk of BSI than non-migrants (adjusted IRR 1.19, 95%CI 1.01–1.40). Family-reunified migrants and refugees had a higher risk of Gram-negative BSIs (adjusted IRR 1.23, 95%CI 1.00–1.51 and 1.57, 95%CI 1.32–1.86), respectively, and a lower risk of Gram-positive BSIs (adjusted IRR 0.65, 95%CI 0.51–0.83 and 0.77, 95%CI 0.63–0.95), respectively, compared to non-migrants. Originating from Southeast Asia and the Pacific was associated with an increased risk of BSI compared to non-migrants (adjusted IRR 1.26, 95%CI 1.07–1.49). We found no differences in the adjusted 30-day or 90-day mortality according to migrant status. Conclusions: Vulnerability towards BSI differs according to migrant status. Refugees had a higher risk of BSI overall. Both refugees and family-reunified migrants had a higher incidence of Gram-negative BSI than non-migrants. Similarly, migrants from Southeast Asia and the Pacific had a higher risk of BSI than non-migrants.",
keywords = "Bloodstream infection, Family-reunified migrants, Migrants, Public health, Refugees",
author = "Nielsen, {Rikke Thoft} and Marie Norredam and Sch{\o}nheyder, {Henrik Carl} and Petersen, {J{\o}rgen Holm} and Knudsen, {Jenny Dahl} and Jarl{\o}v, {Jens Otto} and Andersen, {Christian {\O}stergaard}",
note = "Copyright {\textcopyright} 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.",
year = "2021",
month = feb,
day = "4",
doi = "10.1016/j.cmi.2021.01.026",
language = "English",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Wiley-Blackwell Publishing Ltd",

}

RIS

TY - JOUR

T1 - The effect of migration on the incidence and mortality of bloodstream infection

T2 - a Danish register-based cohort study

AU - Nielsen, Rikke Thoft

AU - Norredam, Marie

AU - Schønheyder, Henrik Carl

AU - Petersen, Jørgen Holm

AU - Knudsen, Jenny Dahl

AU - Jarløv, Jens Otto

AU - Andersen, Christian Østergaard

N1 - Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

PY - 2021/2/4

Y1 - 2021/2/4

N2 - Objectives: To investigate bloodstream infection (BSI) related to migrant status by comparing the incidence and mortality in migrants with that in non-migrants. Methods: In this register-based cohort study we linked a cohort of migrants and non-migrants with a bacteraemia database covering two regions in Denmark. We included first-time BSI between January 2000 and December 2015 in individuals ≥18 years. Migrants were categorized according to status: refugees or family-reunified migrants. Incidence rate ratio and mortality rate ratio were analysed using Poisson regression. Results: We identified 493 080 non-migrants, of which 3405 had BSI, and 80 740 migrants with 576 cases; of the latter, 40 222 were family-reunified migrants with 226 cases and 40 518 were refugees with 350 cases. Refugees had a higher risk of BSI than non-migrants (adjusted IRR 1.19, 95%CI 1.01–1.40). Family-reunified migrants and refugees had a higher risk of Gram-negative BSIs (adjusted IRR 1.23, 95%CI 1.00–1.51 and 1.57, 95%CI 1.32–1.86), respectively, and a lower risk of Gram-positive BSIs (adjusted IRR 0.65, 95%CI 0.51–0.83 and 0.77, 95%CI 0.63–0.95), respectively, compared to non-migrants. Originating from Southeast Asia and the Pacific was associated with an increased risk of BSI compared to non-migrants (adjusted IRR 1.26, 95%CI 1.07–1.49). We found no differences in the adjusted 30-day or 90-day mortality according to migrant status. Conclusions: Vulnerability towards BSI differs according to migrant status. Refugees had a higher risk of BSI overall. Both refugees and family-reunified migrants had a higher incidence of Gram-negative BSI than non-migrants. Similarly, migrants from Southeast Asia and the Pacific had a higher risk of BSI than non-migrants.

AB - Objectives: To investigate bloodstream infection (BSI) related to migrant status by comparing the incidence and mortality in migrants with that in non-migrants. Methods: In this register-based cohort study we linked a cohort of migrants and non-migrants with a bacteraemia database covering two regions in Denmark. We included first-time BSI between January 2000 and December 2015 in individuals ≥18 years. Migrants were categorized according to status: refugees or family-reunified migrants. Incidence rate ratio and mortality rate ratio were analysed using Poisson regression. Results: We identified 493 080 non-migrants, of which 3405 had BSI, and 80 740 migrants with 576 cases; of the latter, 40 222 were family-reunified migrants with 226 cases and 40 518 were refugees with 350 cases. Refugees had a higher risk of BSI than non-migrants (adjusted IRR 1.19, 95%CI 1.01–1.40). Family-reunified migrants and refugees had a higher risk of Gram-negative BSIs (adjusted IRR 1.23, 95%CI 1.00–1.51 and 1.57, 95%CI 1.32–1.86), respectively, and a lower risk of Gram-positive BSIs (adjusted IRR 0.65, 95%CI 0.51–0.83 and 0.77, 95%CI 0.63–0.95), respectively, compared to non-migrants. Originating from Southeast Asia and the Pacific was associated with an increased risk of BSI compared to non-migrants (adjusted IRR 1.26, 95%CI 1.07–1.49). We found no differences in the adjusted 30-day or 90-day mortality according to migrant status. Conclusions: Vulnerability towards BSI differs according to migrant status. Refugees had a higher risk of BSI overall. Both refugees and family-reunified migrants had a higher incidence of Gram-negative BSI than non-migrants. Similarly, migrants from Southeast Asia and the Pacific had a higher risk of BSI than non-migrants.

KW - Bloodstream infection

KW - Family-reunified migrants

KW - Migrants

KW - Public health

KW - Refugees

UR - http://www.scopus.com/inward/record.url?scp=85103329122&partnerID=8YFLogxK

U2 - 10.1016/j.cmi.2021.01.026

DO - 10.1016/j.cmi.2021.01.026

M3 - Journal article

C2 - 33549766

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

ER -

ID: 62062818