title: Nosocomial bloodstream infections due to viridans streptococci in haematological and non-haematological patients: species distribution and antimicrobial resistance.
abstract: OBJECTIVE
  We studied the species distribution and antimicrobial susceptibility of viridans streptococci (VS) isolates causing nosocomial bloodstream infections (BSIs) in Finnish hospitals.
  
  
  METHODS
  Patients with nosocomial BSIs due to VS were identified through a hospital-wide prospective laboratory-based surveillance in two university and two regional hospitals during September 1998-August 2001. Isolates of VS were sent to the reference laboratory for species confirmation and antimicrobial susceptibility testing.
  
  
  RESULTS
  A total of 2038 nosocomial BSIs were identified; 108 (5%) of the BSIs were caused by VS. Of the VS BSIs, 66% were in patients with a haematological malignancy, 14% in patients with a solid tumour and 18% in patients who had undergone surgery preceding the infection. The most common species group identified was Streptococcus mitis (82%). High-level penicillin resistance (> or = 4 mg/L) and cefotaxime resistance (> or = 4mg/L) were present in 5% and 4% of isolates, respectively; both were detected only in haematological patients. However, in non-haematological patients, resistance to erythromycin (17%), and reduced susceptibility to levofloxacin (14%) and penicillin (19%) were common.
  
  
  CONCLUSIONS
  The resistance problems in VS are not limited to haematological patients. These findings may have significant clinical implications in the choice of both empirical antibiotic and antimicrobial prophylaxis regimens.
authors.affiliation: Departments of Infectious Disease Epidemiology and Microbiology, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki. outi.lyytikainen@ktl.fi
authors.forename: Outi
authors.initials: O
authors.lastname: Lyytikäinen
authors.forename: Merja
authors.initials: M
authors.lastname: Rautio
authors.forename: Petteri
authors.initials: P
authors.lastname: Carlson
authors.forename: Veli-Jukka
authors.initials: VJ
authors.lastname: Anttila
authors.forename: Risto
authors.initials: R
authors.lastname: Vuento
authors.forename: Hannu
authors.initials: H
authors.lastname: Sarkkinen
authors.forename: Anja
authors.initials: A
authors.lastname: Kostiala
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Väisänen
authors.forename: Arja
authors.initials: A
authors.lastname: Kanervo
authors.forename: Petri
authors.initials: P
authors.lastname: Ruutu
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial / Q000187:drug effects / Q000502:physiology*; D019337:Hematologic Neoplasms / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D034363:Viridans Streptococci / Q000187:drug effects* / Q000254:growth & development
chemical_list: D000890:Anti-Infective Agents