Nosocomial bloodstream infections in United States hospitals: A three-year analysis
Nosocomial bloodstream infections in United States hospitals: A three-year analysis
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DOI：
10.1086/520192
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发表时间：
1999-08-01
影响因子：
11.8
通讯作者：
Wenzel, RP
中科院分区：
文献类型：
--
作者：
Edmond, MB;Wallace, SE;Wenzel, RP
医院内血流感染是发病率和死亡率的重要原因。在这项研究中，在49家医院进行的为期3年的院内血流感染同步监测发现了> 10，000例感染。革兰氏阳性菌占64%，革兰氏阴性菌占27%，真菌占8%。最常见的微生物是凝固酶阴性葡萄球菌（32%），金黄色葡萄球菌（16%）和肠球菌（11%），肠杆菌属，沙雷氏菌属，凝固酶阴性葡萄球菌和念珠菌更容易引起重症监护病房患者的感染，在中性粒细胞减少患者中，草绿色链球菌明显更常见。凝固酶阴性葡萄球菌是除大肠埃希菌外最常见的临床病原菌，29%的葡萄球菌对甲氧西林耐药。金黄色葡萄球菌分离株和80%的凝固酶阴性葡萄球菌。肠球菌对万古霉素的耐药性是种属依赖性的，3%的粪肠球菌菌株和50%的屎肠球菌菌株显示出耐药性，这些数据可能使临床医生能够更好地针对医院获得性菌血症病例进行经验性治疗。
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.