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Predominance of Gram-negative bacilli and increasing antimicrobial resistance in nosocomial bloodstream infections at a university hospital in southern Taiwan, 1996-2003.
J Microbiol Immunol Infect 2006; 39(2):135-43JM

Abstract

BACKGROUND AND PURPOSE

While nosocomial infections cause substantial morbidity and mortality, the availability of timely and accurate epidemiological information on nosocomial pathogens is essential to the appropriate selection of empirical therapy. This study analyzed nosocomial bloodstream infections (NBSIs) surveillance data to determine trends in the distribution of pathogens and antimicrobial susceptibilities of these pathogens.

METHODS

During the period from 1996 to 2003 at National Cheng Kung University Hospital, patients with NBSIs were enrolled in the study, and the ranking of pathogens and status of antimicrobial resistance were determined.

RESULTS

From 1996 to 2003, there were 4,038 episodes of NBSIs. The overall incidence was 1.79 episodes per 1,000 inpatient-days. Aerobic Gram-negative bacilli, Gram-positive cocci, fungi, and anaerobes were responsible for 51%, 37%, 10%, and 1.6% of NBSIs, respectively. The 5 leading pathogens were coagulase-negative staphylococci (16% of NBSIs), Staphylococcus aureus (13%), Candida spp. (10%), Acinetobacter baumannii (8%), and Escherichia coli (8%). Oxacillin resistance was found in 90% of coagulase-negative staphylococci and 75% of S. aureus isolates. In contrast to Enterococcus faecalis, in which only 1% of isolates were resistant to ampicillin, 78% of Enterococcus faecium isolates were resistant to ampicillin. The emerging antimicrobial-resistant Gram-negative pathogens included multidrug-resistant A. baumannii, cephalosporin- or fluoroquinolone-resistant E. coli, and extended-spectrum beta-lactamase producing Klebsiella pneumoniae and E. coli. Despite the annual increase in the use of fluconazole, Candida albicans (54%) remained the most common causative pathogen of nosocomial candidemia.

CONCLUSIONS

In summary, Gram-negative bacilli predominated among pathogens causing NBSIs and an upsurge in the threat of antimicrobial resistance in our hospital occurred during the 8-year period. Surveillance of the characteristics of NBSIs and antimicrobial resistance patterns, together with appropriate antibiotic and infection control measures, should be reinforced.

Authors+Show Affiliations

Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16604246

Citation

Wu, Chi-Jung, et al. "Predominance of Gram-negative Bacilli and Increasing Antimicrobial Resistance in Nosocomial Bloodstream Infections at a University Hospital in Southern Taiwan, 1996-2003." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 39, no. 2, 2006, pp. 135-43.
Wu CJ, Lee HC, Lee NY, et al. Predominance of Gram-negative bacilli and increasing antimicrobial resistance in nosocomial bloodstream infections at a university hospital in southern Taiwan, 1996-2003. J Microbiol Immunol Infect. 2006;39(2):135-43.
Wu, C. J., Lee, H. C., Lee, N. Y., Shih, H. I., Ko, N. Y., Wang, L. R., & Ko, W. C. (2006). Predominance of Gram-negative bacilli and increasing antimicrobial resistance in nosocomial bloodstream infections at a university hospital in southern Taiwan, 1996-2003. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 39(2), pp. 135-43.
Wu CJ, et al. Predominance of Gram-negative Bacilli and Increasing Antimicrobial Resistance in Nosocomial Bloodstream Infections at a University Hospital in Southern Taiwan, 1996-2003. J Microbiol Immunol Infect. 2006;39(2):135-43. PubMed PMID: 16604246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predominance of Gram-negative bacilli and increasing antimicrobial resistance in nosocomial bloodstream infections at a university hospital in southern Taiwan, 1996-2003. AU - Wu,Chi-Jung, AU - Lee,Hsin-Chun, AU - Lee,Nan-Yao, AU - Shih,Hsin-I, AU - Ko,Nai-Ying, AU - Wang,Li-Rong, AU - Ko,Wen-Chien, PY - 2006/4/11/pubmed PY - 2006/8/19/medline PY - 2006/4/11/entrez SP - 135 EP - 43 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 39 IS - 2 N2 - BACKGROUND AND PURPOSE: While nosocomial infections cause substantial morbidity and mortality, the availability of timely and accurate epidemiological information on nosocomial pathogens is essential to the appropriate selection of empirical therapy. This study analyzed nosocomial bloodstream infections (NBSIs) surveillance data to determine trends in the distribution of pathogens and antimicrobial susceptibilities of these pathogens. METHODS: During the period from 1996 to 2003 at National Cheng Kung University Hospital, patients with NBSIs were enrolled in the study, and the ranking of pathogens and status of antimicrobial resistance were determined. RESULTS: From 1996 to 2003, there were 4,038 episodes of NBSIs. The overall incidence was 1.79 episodes per 1,000 inpatient-days. Aerobic Gram-negative bacilli, Gram-positive cocci, fungi, and anaerobes were responsible for 51%, 37%, 10%, and 1.6% of NBSIs, respectively. The 5 leading pathogens were coagulase-negative staphylococci (16% of NBSIs), Staphylococcus aureus (13%), Candida spp. (10%), Acinetobacter baumannii (8%), and Escherichia coli (8%). Oxacillin resistance was found in 90% of coagulase-negative staphylococci and 75% of S. aureus isolates. In contrast to Enterococcus faecalis, in which only 1% of isolates were resistant to ampicillin, 78% of Enterococcus faecium isolates were resistant to ampicillin. The emerging antimicrobial-resistant Gram-negative pathogens included multidrug-resistant A. baumannii, cephalosporin- or fluoroquinolone-resistant E. coli, and extended-spectrum beta-lactamase producing Klebsiella pneumoniae and E. coli. Despite the annual increase in the use of fluconazole, Candida albicans (54%) remained the most common causative pathogen of nosocomial candidemia. CONCLUSIONS: In summary, Gram-negative bacilli predominated among pathogens causing NBSIs and an upsurge in the threat of antimicrobial resistance in our hospital occurred during the 8-year period. Surveillance of the characteristics of NBSIs and antimicrobial resistance patterns, together with appropriate antibiotic and infection control measures, should be reinforced. SN - 1684-1182 UR - https://www.unboundmedicine.com/medline/citation/16604246/Predominance_of_Gram_negative_bacilli_and_increasing_antimicrobial_resistance_in_nosocomial_bloodstream_infections_at_a_university_hospital_in_southern_Taiwan_1996_2003_ L2 - https://medlineplus.gov/antibioticresistance.html DB - PRIME DP - Unbound Medicine ER -