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

TLDR

Nosocomial bloodstream infections are important causes of morbidity and mortality. The study aimed to conduct concurrent surveillance across 49 hospitals over three years to detect nosocomial bloodstream infections. Concurrent surveillance was performed at 49 hospitals over a three‑year period, detecting more than 10,000 infections. Gram‑positive organisms accounted for 64% of cases, with coagulase‑negative staphylococci (32%) most frequent; methicillin resistance was present in 29% of S.

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.