Nosocomial Bloodstream Infections in United States Hospitals: A Three-Year Analysis

Clin Infect Dis. 1999 Aug;29(2):239-44. doi: 10.1086/520192.

Abstract

Nosocomial bloodstream infections are important causes of morbidity and mortality. In this study, concurrent surveillance for nosocomial bloodstream infections at 49 hospitals over a 3-year period detected >10,000 infections. Gram-positive organisms accounted for 64% of cases, gram-negative organisms accounted for 27%, and 8% were caused by fungi. The most common organisms were coagulase-negative staphylococci (32%), Staphylococcus aureus (16%), and enterococci (11%). Enterobacter, Serratia, coagulase-negative staphylococci, and Candida were more likely to cause infections in patients in critical care units. In patients with neutropenia, viridans streptococci were significantly more common. Coagulase-negative staphylococci were the most common pathogens on all clinical services except obstetrics, where Escherichia coli was most common. Methicillin resistance was detected in 29% of S. aureus isolates and 80% of coagulase-negative staphylococci. Vancomycin resistance in enterococci was species-dependent--3% of Enterococcus faecalis strains and 50% of Enterococcus faecium isolates displayed resistance. These data may allow clinicians to better target empirical therapy for hospital-acquired cases of bacteremia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / blood
  • Bacteremia / microbiology*
  • Candida / classification
  • Candida / isolation & purification
  • Cross Infection / blood
  • Cross Infection / microbiology*
  • Enterococcus / classification
  • Enterococcus / isolation & purification
  • Fungemia / blood
  • Fungemia / microbiology*
  • Gram-Negative Bacteria / classification
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / classification
  • Gram-Positive Bacteria / isolation & purification
  • Hospitals
  • Humans
  • Neutropenia
  • Staphylococcus / classification
  • Staphylococcus / isolation & purification
  • United States