Kåre Mølbak ^1,2* Christian Østergaard Andersen ^3,4 Ram Benny Dessau ^5,6,7 Svend Ellermann-Eriksen ⁸ Sophie Gubbels ⁵ Thøger Jensen ⁹ Jenny Dahl Knudsen ¹⁰ Brian Kristensen ¹¹ Lisbeth Lützen ¹² John Coia ¹³ Bente Olesen ¹⁴ Mette Pinholt ⁴ Flemming Scheutz ¹⁵ Ute Wolff Sönksen ¹⁶ Kirstine K. Søgaard ¹⁷ Marianne Voldstedlund ⁵

• ¹ Epidemiological Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
• ² Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Capital Region of Denmark, Denmark
• ³ Department of Diagnostic and Infectious disease preparedness, Statens Serum Institut, Copenhagen, Denmark
• ⁴ Department of Clinical Microbiology, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
• ⁵ Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen, Denmark
• ⁶ Department of Clinical Microbiology, Zealand University Hospital, Slagelse, Denmark
• ⁷ Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
• ⁸ Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
• ⁹ Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
• ¹⁰ Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
• ¹¹ Department of Infectious Diseases Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
• ¹² Department of Clinical Microbiology, Sygehus Lillebælt, Vejle, Denmark
• ¹³ Department of Regional Health Research, Research Unit of Clinical Microbiology, Esbjerg, Denmark
• ¹⁴ Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
• ¹⁵ The International Escherichia and Klebsiella Centre, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
• ¹⁶ Department of Bacteria, Parasites and Fungi, State Serum Institute(SSI), Copenhagen, Denmark
• ¹⁷ Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark

Except for a few countries, comprehensive all-cause surveillance for bacteremia is not part of mandatory routine public health surveillance. We argue that time has come to include automated surveillance for bacteremia in the national surveillance systems, and explore diverse approaches and challenges in establishing bacteremia monitoring. Assessed against proposed criteria, surveillance for bacteremia should be given high priority. This is based on severity, burden of illness, health gains obtained by improved treatment and prevention, risk of outbreaks (including health care associated infections), the emergence of antimicrobial drug resistance as well as the changing epidemiology of bacteremia which is seen along with an ageing population and advances in medical care. The establishment of comprehensive surveillance for bacteremia was until recently conceived as an insurmountable task. With computerized systems in clinical microbiology, surveillance by real-time data capture has become achievable. This calls for re-addressing the question of including bacteremia among the conditions under mandatory surveillance. Experiences from several countries, including Denmark, show that this is feasible. We propose enhanced international collaboration, legislative action, and funding to address the challenges and opportunities.