Nosocomial bloodstream infections in Brazilian hospitals: analysis of 2,563 cases from a prospective nationwide surveillance study

Alexandre R Marra; Luis Fernando Aranha Camargo; Antonio Carlos Campos Pignatari; Teresa Sukiennik; Paulo Renato Petersen Behar; Eduardo Alexandrino Servolo Medeiros; Julival Ribeiro; Evelyne Girão; Luci Correa; Carla Guerra; Carlos Brites; Carlos Alberto Pires Pereira; Irna Carneiro; Marise Reis; Marta Antunes de Souza; Regina Tranchesi; Cristina U Barata; Michael B Edmond; Brazilian SCOPE Study Group

doi:10.1128/JCM.00376-11

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Nosocomial bloodstream infections in Brazilian hospitals: analysis of 2,563 cases from a prospective nationwide surveillance study

Journal article

Open access

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Nosocomial bloodstream infections in Brazilian hospitals: analysis of 2,563 cases from a prospective nationwide surveillance study

Alexandre R Marra, Luis Fernando Aranha Camargo, Antonio Carlos Campos Pignatari, Teresa Sukiennik, Paulo Renato Petersen Behar, Eduardo Alexandrino Servolo Medeiros, Julival Ribeiro, Evelyne Girão, Luci Correa, Carla Guerra, …

Journal of clinical microbiology, Vol.49(5), pp.1866-1871

05/2011

DOI: 10.1128/JCM.00376-11

PMCID: PMC3122653

PMID: 21411591

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Abstract

Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. Data from a nationwide, concurrent surveillance study, Brazilian SCOPE (Surveillance and Control of Pathogens of Epidemiological Importance), were used to examine the epidemiology and microbiology of nBSIs at 16 Brazilian hospitals. In our study 2,563 patients with nBSIs were included from 12 June 2007 to 31 March 2010. Ninety-five percent of BSIs were monomicrobial. Gram-negative organisms caused 58.5% of these BSIs, Gram-positive organisms caused 35.4%, and fungi caused 6.1%. The most common pathogens (monomicrobial) were Staphylococcus aureus (14.0%), coagulase-negative staphylococci (CoNS) (12.6%), Klebsiella spp. (12.0%), and Acinetobacter spp. (11.4%). The crude mortality was 40.0%. Forty-nine percent of nBSIs occurred in the intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 622 patients (24.3%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (70.3%). Methicillin resistance was detected in 157 S. aureus isolates (43.7%). Of the Klebsiella sp. isolates, 54.9% were resistant to third-generation cephalosporins. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 55.9% and 36.8%, respectively, were resistant to imipenem. In our multicenter study, we found high crude mortality and a high proportion of nBSIs due to antibiotic-resistant organisms.

Prospective Studies

Humans

Middle Aged

Cross Infection - mortality

Child, Preschool

Drug Resistance, Bacterial

Bacteremia - mortality

Infant

Male

Bacteremia - microbiology

Young Adult

Anti-Bacterial Agents - therapeutic use

Aged, 80 and over

Bacteria - classification

Adult

Child

Bacterial Infections - microbiology

Brazil - epidemiology

Infant, Newborn

Cross Infection - epidemiology

Risk Factors

Bacteria - isolation & purification

Hospitals

Cross Infection - microbiology

Adolescent

Bacterial Infections - epidemiology

Bacteremia - epidemiology

Aged

Anti-Bacterial Agents - pharmacology

In Vitro Techniques

Bacterial Infections - mortality

Details

Title: Subtitle: Nosocomial bloodstream infections in Brazilian hospitals: analysis of 2,563 cases from a prospective nationwide surveillance study
Creators: Alexandre R Marra - Hospital Israelita Albert Einstein, São Paulo, Brazil1. alexmarra@einstein.br
Luis Fernando Aranha Camargo
Antonio Carlos Campos Pignatari
Teresa Sukiennik
Paulo Renato Petersen Behar
Eduardo Alexandrino Servolo Medeiros
Julival Ribeiro
Evelyne Girão
Luci Correa
Carla Guerra
Carlos Brites
Carlos Alberto Pires Pereira
Irna Carneiro
Marise Reis
Marta Antunes de Souza
Regina Tranchesi
Cristina U Barata
Michael B Edmond
Brazilian SCOPE Study Group
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.49(5), pp.1866-1871
Publisher: United States
DOI: 10.1128/JCM.00376-11
PMID: 21411591
PMCID: PMC3122653
ISSN: 1098-660X
eISSN: 1098-660X
Language: English
Date published: 05/2011
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9983905644202771

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