Nosocomial Bloodstream Infections: Secular Trends in a Statewide Surveillance Program in Virginia

Abstract

Over a 7-year period (1978-1984) the authors studied the rates of nosocomial bloodstream infections in acute-care hospitals participating in a statewide surveillance network in Virginia. A total of 4,617 hospital-acquired bloodstream infections were documented among 1,807,989 patients at risk for an overall rate of 25.5 cases per 10,000 patient admissions/discharges (annual range = 22.1 to 30.7). Compliance of reporting for Virginia hospitals averaged 58% (1 to 5 monthly reports in a study year), and 39% (greater than or equal to 6 monthly reports annually). Significant changes in bloodstream infection rates (cases per 10,000 patient admissions/discharges) due to specific pathogens included the following: coagulase-negative staphylococci increased from a rate of 1.3 to 4.5 (P = .0003), and those due to all gram-positive cocci increased from a rate of 7.5 to 11.4 (P = .03). Candida species increased from a rate of 0.1 to 1.5 (P = .005). The data show a continuing rise of nosocomial Candida BSI and clearly document the re-emergence of gram-positive cocci as major nosocomial bloodstream pathogens.

Efeito da infecção hospitalar da corrente sanguínea por Staphylococcus aureus resistente à oxacilina sobre a letalidade e o tempo de hospitalização

“…Foi definido como caso o paciente adulto com pelo menos uma hemocultura positiva para SARO que tivesse apresentado tratamento com um glicopeptídeo (vancomicina ou teicoplanina) e evidên-cia de sepses, definida pela presença de dois ou mais dos seguintes sintomas ou sinais: temperatura axilar maior que 38 0 C ou menor que 36 0 C; freqüên-cia cardíaca maior que 90 batimentos por minuto; freqüência respiratória maior que 20 incursões por minuto, PaCO 2 menor que 32 mmHg, hemograma com contagem de leucócitos superior a 12 000 ou inferior a 4 000 mm 3 .…”

Laboratory diagnosis of invasive candidiasis

“…Rare genetic defects in immune response are manifested by chronic mucocutaneous candidiasis. In the past three decades, with the use of potent antibacterial, immunosuppressive, and cytotoxic drugs, lethal invasive candidiasis in compromised hosts has been described with increasing frequency (78,93). These infections have sparked great interest in all aspects of Candida infections, including their diagnosis.…”

New Aspects for the Diagnosis of Invasive Fungal Disease in Oncological Patients

“…burn patients, patients in surgical and neonatal intensive care units, and HIV-infected individuals are major risk groups [3]. The most common causes of deep fungal infections are Candida and Aspergillus species, however, uncommon fungal pathogens such as species of Mucorales, Trichosporon, and Fusarium are reported as causative pathogens with increasing frequencies [1,2,[4][5][6], The incidence of invasive fungal infections (I FI) in patients with hematological malignancies has been estimated at 10-20% [7]. Recipients of an allogeneic stem cell transplant (SCT) are at a very high risk to develop IF1 in the posttrans plant period [8][9][10].…”