title: Nosocomial bloodstream infections in United States hospitals: a three-year analysis.
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.
authors.affiliation: Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond 23298-0663, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Edmond
authors.forename: S E
authors.initials: SE
authors.lastname: Wallace
authors.forename: D K
authors.initials: DK
authors.lastname: McClish
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: R N
authors.initials: RN
authors.lastname: Jones
authors.forename: R P
authors.initials: RP
authors.lastname: Wenzel
mesh_terms: D016470:Bacteremia / Q000097:blood / Q000382:microbiology*; D002175:Candida / Q000145:classification / Q000302:isolation & purification; D003428:Cross Infection / Q000097:blood / Q000382:microbiology*; D016983:Enterococcus / Q000145:classification / Q000302:isolation & purification; D016469:Fungemia / Q000097:blood / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification; D006761:Hospitals; D006801:Humans; D009503:Neutropenia; D013210:Staphylococcus / Q000145:classification / Q000302:isolation & purification; D014481:United States