title: Bacteraemia and antibiotic resistance of its pathogens reported in England and Wales between 1990 and 1998: trend analysis.
abstract: OBJECTIVE
  Determination of causes, trends, and antibiotic resistance in reports of bacterial pathogens isolated from blood in England and Wales from 1990 to 1998.
  
  
  METHODS
  Description of bacterial isolates from blood, judged to be clinically significant by microbiology staff, reported to the Communicable Disease Surveillance Centre.
  
  
  METHODS
  Microbiology laboratories in England and Wales.
  
  
  METHODS
  Patients yielding clinically significant isolates from blood.
  
  
  METHODS
  Frequency and Poisson regression analyses for trend of reported causes of bacteraemia and proportions of antibiotic resistant isolates.
  
  
  RESULTS
  There was an upward trend in total numbers of reports of bacteraemia. The five most cited organisms accounted for over 60% of reports each year. There was a substantial increase in the proportion of reports of Staphylococcus aureus resistant to methicillin, Streptococcus pneumoniae resistance to penicillin and erythromycin, and Enterococcus faecalis and Enterococcus faecium resistance to vancomycin. No increase was seen in resistance of Escherichia coli to gentamicin.
  
  
  CONCLUSIONS
  Reports from laboratories provide valuable information on trends and antibiotic resistance in bacteraemia and show a worrying increase in resistance to important antibiotics.
authors.affiliation: Public Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ. mreacher@phls.nhs.uk
authors.forename: M H
authors.initials: MH
authors.lastname: Reacher
authors.forename: A
authors.initials: A
authors.lastname: Shah
authors.forename: D M
authors.initials: DM
authors.lastname: Livermore
authors.forename: M C
authors.initials: MC
authors.lastname: Wale
authors.forename: C
authors.initials: C
authors.lastname: Graham
authors.forename: A P
authors.initials: AP
authors.lastname: Johnson
authors.forename: H
authors.initials: H
authors.lastname: Heine
authors.forename: M A
authors.initials: MA
authors.lastname: Monnickendam
authors.forename: K F
authors.initials: KF
authors.lastname: Barker
authors.forename: D
authors.initials: D
authors.lastname: James
authors.forename: R C
authors.initials: RC
authors.lastname: George
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D004352:Drug Resistance, Microbial; D004739:England / Q000453:epidemiology; D013293:Enterococcus faecalis / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000188:drug therapy; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006801:Humans; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000187:drug effects; D013290:Streptococcal Infections / Q000188:drug therapy; D013296:Streptococcus pneumoniae / Q000187:drug effects; D014852:Wales / Q000453:epidemiology