Nosocomial Bloodstream Infections in United States Hospitals: A Three‐Year Analysis

Abstract

Nosocomial bloodstream infections are important causes of morbidity and mortality. In this study, concurrent surveillance for nosocomial bloodstream infections at 49 hospitals over a 3-year period detected >10,000 infections. Gram-positive organisms accounted for 64% of cases, gram-negative organisms accounted for 27%, and 8% were caused by fungi. The most common organisms were coagulase-negative staphylococci (32%), Staphylococcus aureus (16%), and enterococci (11%). Enterobacter, Serratia, coagulase-negative staphylococci, and Candida were more likely to cause infections in patients in critical care units. In patients with neutropenia, viridans streptococci were significantly more common. Coagulase-negative staphylococci were the most common pathogens on all clinical services except obstetrics, where Escherichia coli was most common. Methicillin resistance was detected in 29% of S. aureus isolates and 80% of coagulase-negative staphylococci. Vancomycin resistance in enterococci was species-dependent--3% of Enterococcus faecalis strains and 50% of Enterococcus faecium isolates displayed resistance. These data may allow clinicians to better target empirical therapy for hospital-acquired cases of bacteremia.

Copper(II) complexes of coumarin-derived Schiff bases and their anti-Candida activity

“…The development of azole-based antifungal drugs has considerably impacted on the fight against fungal infections, but the necessity to use high doses or combinations of drug therapies results in considerable side effects in patients and resistance to these drugs has also been reported [4][5][6]. Indeed, the repertoire of available antifungal chemotherapeutic agents is inadequate to treat life-threatening infections that are characterised by morbidities that exceed those due to the most important bacterial and viral diseases [7][8][9][10][11][12][13]. Therefore, there is an urgent need to generate new, efficacious, non-toxic compounds with broad-spectrum antifungal activity.…”

Serum Procalcitonin for Discrimination of Blood Contamination from Bloodstream Infection due to Coagulase-Negative Staphylococci

“…Coagulase-negative staphylococci as ubiquitous skin commensals are both, the most common cause of nosocomial bloodstream infection (BSI) and blood culture contamination [1][2][3]. It is important to distinguish blood contamination from BSI to promptly initiate an adequate therapy in BSI and, in contamination to avoid unnecessary antimicrobial usage and healthcare expenditures, reduce the selection pressure on microorganisms and prevent potential drug adverse events.…”

Vancomycin-resistant enterococci in liver transplant recipients

“…3 In a recently published European study, vancomycin resistance was detected in 0.06% of E faecalis isolates and 3.8% of E faecium isolates, 4 whereas in a study of enterococcal bloodstream isolates in the United States, 50.5% of E faecium isolates and 3.1% of E faecalis isolates were resistant to vancomycin. 5 The natural history of VRE infection is typically that VRE colonization, predominantly of the gastrointestinal tract, precedes infection. Widespread colonization of transplant populations may occur with comparatively small numbers of documented infections.…”