title: Secular trends in bloodstream infection caused by antimicrobial-resistant bacteria in New Jersey hospitals, 1991 to 1995.
abstract: 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.
authors.affiliation: Hospital Infections Program, National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.
authors.forename: J I
authors.initials: JI
authors.lastname: Tokars
authors.forename: S M
authors.initials: SM
authors.lastname: Paul
authors.forename: G L
authors.initials: GL
authors.lastname: Crane
authors.forename: M S
authors.initials: MS
authors.lastname: Cetron
authors.forename: L
authors.initials: L
authors.lastname: Finelli
authors.forename: W R
authors.initials: WR
authors.lastname: Jarvis
mesh_terms: 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
chemical_list: D014640:Vancomycin; D015378:Imipenem