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Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study
Journal article   Open access   Peer reviewed

Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study

Hilmar Wisplinghoff, Tammy Bischoff, Sandra M Tallent, Harald Seifert, Richard P Wenzel and Michael B Edmond
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.39(3), pp.309-317
08/01/2004
DOI: 10.1086/421946
PMID: 15306996
url
https://doi.org/10.1086/421946View
Published (Version of record) Open Access

Abstract

Nosocomial bloodstream infections (BSIs) are important causes of morbidity and mortality in the United States. Data from a nationwide, concurrent surveillance study (Surveillance and Control of Pathogens of Epidemiological Importance [SCOPE]) were used to examine the secular trends in the epidemiology and microbiology of nosocomial BSIs. Our study detected 24,179 cases of nosocomial BSI in 49 US hospitals over a 7-year period from March 1995 through September 2002 (60 cases per 10,000 hospital admissions). Eighty-seven percent of BSIs were monomicrobial. Gram-positive organisms caused 65% of these BSIs, gram-negative organisms caused 25%, and fungi caused 9.5%. The crude mortality rate was 27%. The most-common organisms causing BSIs were coagulase-negative staphylococci (CoNS) (31% of isolates), Staphylococcus aureus (20%), enterococci (9%), and Candida species (9%). The mean interval between admission and infection was 13 days for infection with Escherichia coli, 16 days for S. aureus, 22 days for Candida species and Klebsiella species, 23 days for enterococci, and 26 days for Acinetobacter species. CoNS, Pseudomonas species, Enterobacter species, Serratia species, and Acinetobacter species were more likely to cause infections in patients in intensive care units (P<.001). In neutropenic patients, infections with Candida species, enterococci, and viridans group streptococci were significantly more common. The proportion of S. aureus isolates with methicillin resistance increased from 22% in 1995 to 57% in 2001 (P<.001, trend analysis). Vancomycin resistance was seen in 2% of Enterococcus faecalis isolates and in 60% of Enterococcus faecium isolates. In this study, one of the largest multicenter studies performed to date, we found that the proportion of nosocomial BSIs due to antibiotic-resistant organisms is increasing in US hospitals.
 United States - epidemiology Prospective Studies Humans Middle Aged Candidiasis - epidemiology Child, Preschool Infant Male Incidence Aged, 80 and over Adult Female Child Cross Infection - epidemiology Sepsis - epidemiology Gram-Positive Bacterial Infections - epidemiology Drug Resistance, Microbial Staphylococcal Infections - epidemiology Adolescent Gram-Negative Bacterial Infections - epidemiology Bacteremia - epidemiology Aged Fungemia - epidemiology Causality Population Surveillance

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