Secular trends in bloodstream infection caused by antimicrobial-resistant bacteria in New Jersey hospitals, 1991 to 1995.
BACKGROUND
Antimicrobial resistance among bacteria is an increasing public health problem. In 1991, New Jersey was the first state to establish statewide, hospital-based surveillance for antimicrobial-resistant bacteria.


METHODS
Each month, all 96 nonfederal New Jersey hospital laboratories complete a form listing the species identity and drug susceptibility results for selected antimicrobial-resistant bacteria isolated from blood cultures from hospital inpatients. Penicillin-resistant Streptococcus pneumoniae and aminoglycoside-resistant gram-negative rods were studied from 1991 to 1995. Vancomycin-resistant enterococci and imipenem-resistant gram-negative rods were studied from 1992 through 1995.


RESULTS
From 1992 to 1995, the vancomycin-resistant enterococci bloodstream infection prevalence rate increased from 11 to 29 per 100,000 hospital admissions (p < 0.001); the rate was higher at larger hospitals, urban and inner-city hospitals, and teaching hospitals. From 1991 to 1995, the penicillin-resistant S. pneumoniae bloodstream infection rate increased from 1.1 to 9.9 per 100,000 admissions (p < 0.001). In contrast, bloodstream infection rates did not change significantly for imipenem-resistant (12.5 during 1992 and 14.1 during 1995, p = 0.4) or aminoglycoside-resistant (8.0 during 1991 and 6.8 during 1995, p = 0.4) gram-negative rods.


CONCLUSIONS
We found that vancomycin-resistant enterococci and penicillin-resistant S. pneumoniae, but neither of two groups of antimicrobial-resistant gram-negative rods, are increasing rapidly in prevalence in New Jersey. Continued monitoring and interventions to slow these increases are needed.
Tokars
J I
JI
Hospital Infections Program, National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.
Paul
S M
SM
Crane
G L
GL
Cetron
M S
MS
Finelli
L
L
Jarvis
W R
WR
D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D003625:Data Collection; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D016983:Enterococcus / Q000187:drug effects*; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage; D008826:Microbial Sensitivity Tests; D009515:New Jersey / Q000453:epidemiology; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology; D015995:Prevalence; D013045:Species Specificity; D013296:Streptococcus pneumoniae / Q000187:drug effects; D014640:Vancomycin / Q000008:administration & dosage
D014640:Vancomycin; D015378:Imipenem