Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States.
A total of 2340 patients with underlying malignancy were identified among 22,631 episodes of nosocomial bloodstream infections (BSIs) in a prospectively collected database for 49 hospitals in the United States (Surveillance and Control of Pathogens of Epidemiologic Importance [SCOPE] Project). Data were obtained for the period of March 1995 through February 2001. Gram-positive organisms accounted for 62% of all BSIs in 1995 and for 76% in 2000 (P<.001), and gram-negative organisms accounted for 22% and 14% of all BSIs for these years, respectively. Neutropenia was observed in 30% of patients, so neutropenic and nonneutropenic patients were compared. In both, the predominant pathogens were coagulase-negative staphylococci (32% of isolates recovered from neutropenic patients and 30% of isolates recovered from nonneutropenic patients). The source of BSI was not determined for 57% of patients. The crude mortality rate was 36% for neutropenic patients and 31% for nonneutropenic patients.
Wisplinghoff
Hilmar
H
Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, 50935 Cologne, Germany. h.wisplinghoff@uni-koeln.de
Seifert
Harald
H
Wenzel
Richard P
RP
Edmond
Michael B
MB
D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D001419:Bacteria / Q000187:drug effects; D003428:Cross Infection / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology