An overview of nosocomial infections, including the role of the microbiology laboratory

Abstract

An estimated 2 million patients develop nosocomial infections in the United States annually. The increasing number of antimicrobial agent-resistant pathogens and high-risk patients in hospitals are challenges to progress in preventing and controlling these infections. While Escherichia coli and Staphylococcus aureus remain the most common pathogens isolated overall from nosocomial infections, coagulase-negative staphylococci (CoNS), organisms previously considered contaminants in most cultures, are now the predominant pathogens in bloodstream infections. The growing number of antimicrobial agent-resistant organisms is troublesome, particularly vancomycin-resistant CoNS and Enterococcus spp. and Pseudomonas aeruginosa resistant to imipenem. The active involvement and cooperation of the microbiology laboratory are important to the infection control program, particularly in surveillance and the use of laboratory services for epidemiologic purposes. Surveillance is used to identify possible infection problems, monitor infection trends, and assess the quality of care in the hospital. It requires high-quality laboratory data that are timely and easily accessible.

The outcome of perioperative wound infection after total hip and knee arthroplasty

“…The CDCP definition relies on clinical signs of infection with a positive microbiological culture from the site of surgery and without clinical evidence of deep involvement. This definition has been shown to be more reliable in predicting the outcome of wound infection in surgical patients [7].…”

Bacterial fibronectin-binding proteins and endothelial cell surface fibronectin mediate adherence of Staphylococcus aureus to resting human endothelial cells

“…Staphylococcus aureus is a major cause of communityacquired and nosocomial sepsis (Emori & Gaynes, 1993 ;Steinberg et al, 1996 ;Communicable Disease Surveillance Centre, 1998). The clinical manifestations are widespread and include bacteraemia, endocarditis, pneumonia, osteomyelitis, septic arthritis and abscess formation.…”

Changes in the Incidence and Etiological Patterns of Bacteremia Associated with Acute Leukemia over a 25-Year Period.

“…Recent data from a Centers for Disease Control and Prevention survey disclosed that the percentage of primary bacteremia among all nosocomial infections increased from 7% between 1980and 1986to 13%between 1990and 1992 (10). Incontrast, the present study showed that the percentage of patients with acute leukemia whodeveloped bacteremia remained almost unchanged during the past 25 years, although the incidence of bacteremia per 1,000 hospital admissions decreased by 108 episodes.…”