Epidemiology of community-acquired and nosocomial bloodstream infections in tropical Australia: a 12-month prospective study.
OBJECTIVE
To define the relative incidence of organisms causing blood stream infections in a tropical setting with a very low prevalence of human immunodeficiency virus infection (<1%).


METHODS
A 12-month prospective study of blood stream infections in 2000 at Royal Darwin Hospital in the tropical north of Australia.


RESULTS
Significant isolates were grown from 257 sets of blood cultures. Staphylococcus aureus was the most common isolate overall (28%); 26% of these were methicillin-resistant (MRSA). Escherichia coli was the most common cause of community-acquired bacteraemia. Burkholderia pseudomallei caused 32% of community acquired, bacteraemic pneumonia; 6% of bacteraemias overall. Vancomycin-resistant enterococci were not isolated. Crude mortality rates (13% overall; 9% attributable mortality) were lower than in most comparable studies.


CONCLUSIONS
The major difference between these findings and surveys performed elsewhere is the presence of B. pseudomallei as a significant cause of bacteraemic community-acquired pneumonia. Our results demonstrate the effects of local environmental and patient characteristics on the range of organisms causing blood stream infections, and emphasize the important role of local microbiology laboratories in guiding empiric antibiotic therapy.
Douglas
Mark W
MW
Department of Infectious Diseases, Royal Darwin Hospital, Casuarina, NT, Australia.
Lum
Gary
G
Roy
Jhumur
J
Fisher
Dale A
DA
Anstey
Nicholas M
NM
Currie
Bart J
BJ
D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008554:Melioidosis / Q000453:epidemiology / Q000401:mortality; D008875:Middle Aged; D015876:Northern Territory / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000401:mortality