In this study, one of the largest multicenter studies performed to date, we found that the proportion of nosocomial BSIs due to antibiotic-resistant organisms is increasing in US hospitals.

Nosocomial BSI occurred predominantly in very young and/or critically ill children. Gram-positive pathogens predominated across all ages, and increasing antimicrobial resistance was observed in pediatric patients.

Nosocomial oxacillin-resistant Staphylococcus aureus (ORSA) bloodstream isolates were tested to determine the prevalence of vancomycin heteroresistance. We screened 619 ORSA nosocomial bloodstream isolates from 36 hospitals between 1997 and 2000. Only one isolate exhibiting heterotypic resistance was detected. Thus, vancomycin heteroresistance in clinical bloodstream isolates remains rare in the United States

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