Trends in bacteraemia on the haematology and oncology units of a UK tertiary referral hospital.
As part of ongoing surveillance of infection in the haematology and oncology units at Belfast City Hospital, microbiologically documented bloodstream infections over three 12-month periods 1994/5, 1998/9 and 1999/00 were reviewed. Gram-positive organisms were the most common cause of blood stream infection in the haematology unit causing 66%, 56% and 64% of episodes of monomicrobial bacteraemia in 1994/5, 1998/9 and 1999/00, respectively. In haematology patients, enterococci have emerged as an important cause of bacteraemia, with increasing levels of glycopeptide resistance, and the 'non-fermenting Gram-negative rods other than Pseudomonas aeruginosa' are an increasingly common cause of monomicrobial and polymicrobial bacteraemia. In oncology patients, Gram-negative organisms (predominantly enterobacteriaceae) were more common than Gram-positive organisms, causing 50% and 54% of monomicrobial bacteraemia in 1998/9 and 1999/00, respectively. Changes in patient population, underlying diseases and chemotherapeutic agents may explain these findings. The spectrum of infection seen in haematology and oncology patients changes as management evolves. Ongoing co-operation between haematologists, oncologists and microbiologists is important to detect trends in epidemiology, which can be used to design empirical antibiotic regimens and guide infection control policies.
Jugo
J
J
Department of Microbiology,Belfast Link Laboratories, Belfast City Hospital, Belfast City Hospital Trust, UK.
Kennedy
R
R
Crowe
M J
MJ
Lamrock
G
G
McClurg
R B
RB
Rooney
P J
PJ
Morris
T C M
TC
Johnston
P G
PG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D004352:Drug Resistance, Microbial; D005260:Female; D006405:Hematology; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D006113:United Kingdom