[Epidemiology of septicemias in a university hospital over 5 yeaars].
Bloodstream infections (are associated with high mortality. The incidence of bloodstream infections is increasing worldwide, with a shift towards multiresistant pathogens such as methicillin-resistant Staphylococcus aureus, enterococci and Candida spp. This study analysed retrospectively 1814 episodes of bacteraemia from 1993 to 1997 at a single tertiary care centre. True bloodstream infections was defined as clinical sepsis and positive blood culture without evidence for contamination of skin bacteria. Of the 1814 episodes, 380 (20.9%) were contaminated, resulting in 1434 true episodes of bloodstream infection. 42% were nosocomial bloodstream infections and one fourth were primary bloodstream infections. The incidence of bloodstream infections increased from 13.0/10,000 patient-days (1993) to 15.8/10,000 patient-days (1997). Mortality increased from 15.4% (1993) to 21% (1997) (p = 0.059). The five most frequently isolated microorganisms were Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, coagulase-negative staphylococci and streptococci. The distribution of bacteria did not change over time from 1993 to 1998. Multiresistant bacteria such as methicillin-resistant Staphylococcus aureus, enterococci, Pseudomonas spp. and yeasts were isolated in less than 5% of episodes. In addition, there is a trend towards decreasing resistance, in contrast to most other institutions in Southern Europe and the US. Further analyses and studies are necessary to answer questions raised by this retrospective study.
Laffer
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RR
Abteilung für Spitalhygiene.
Frei
R
R
Widmer
A F
AF
D016470:Bacteremia / Q000453:epidemiology*; D001424:Bacterial Infections / Q000145:classification / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000453:epidemiology*; D013557:Switzerland / Q000453:epidemiology