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

  • Allan J. Morrison (a1), Carol V. Freer (a1), Mary Ann Searcy (a1), Sandra M. Landry (a1) and Richard P Wenzel (a1)...


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% (≥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.


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1.Haley, RW, Culver, DH, White, JW, et al: The nationwide nosocomial infection rate: A new need for vital statistics. Am J Epidemiol 1985; 121:159167.
2.Centers for Disease Control: National nosocomial infections survey, 1980-1982. NNIS, 1983.
3.Maki, DG: Nosocomial bacteremia: An epidemiologic overview. Am J Med 1981; 70:719732.
4.Townsend, TR, Wenzel, RP: Nosocomial bloodstream infections in a newborn intensive care unit. Am J Epidemiol 1981; 114:7380.
5.McGowan, JE Jr, Barnes, MW, Finland, M: Bacteremia at Boston City Hospital: Occurrence and mortality during 12 selected years (1935-1972) with special reference to hospital-acquired cases. J Infect Dis 1975; 132:316335.
6.Spengler, RF, Greenough, WB III: Hospital costs and mortality attributed to nosocomial bacteremias. JAMA 1978; 240:24552458.
7.Haley, RW, Schaberg, DR, Von Allmen, SD, et al: Estimating the extra charges and prolongation of hospitalization due to nosocomial infections: A comparison of methods. J Infect Dis 1980; 141:248257.
8.Wenzel, RP, Osterman, CA, Townsend, TR, et al: Development of a statewide program for surveillance and reporting of hospital-acquired infections. J Infect Dis 1979; 140:741746.
9.Wenzel, RP, Osterman, CA, Hunting, KJ, et al: Hospital-acquired infections. I. Surveillance in a university hospital. Am J Epidemiol 1976; 103:251260.
10.Daniel, WW: Biostatistics: A Foundation for Analysis in the Health Sciences, ed 3. New York, John Wiley and Sons, 1983, pp 265352.
11.Finland, M, Jones, WF Jr, Barnes, MW: Occurrence of serious bacterial infections since the introduction of antibacterial agents. JAMA 1959; 170:21882197.
12.McCabe, WR, Jackson, GG: Gram negative bacteremia. I. Etiology and ecology. Arch Intern Med 1962; 110:847855.
13.Watson, DP: A case of Staphylococcus albus septicemia. J Royal Army Med Corps 1924; 42:217219.
14.Burchard, KW, Minor, LB, Slotman, GJ, et al: Staphylococcus epidermidis sepsis in surgical patients. Arch Surg 1984; 119:96100.
15.Wilson, TS, Stuart, RD: Staphylococcus albus in wound infection and in septicemia. Can Med Assoc J 1965; 93:816.
16.Christensen, GD, Bisno, AL, Parisi, JT, et al: Nosocomial septicemia due to multiply antibiotic-resistant Staphylococcus epidermidis. Ann Intern Med 1982; 96:110.
17.Smith, IM, Beals, PD, Kingsbury, KR: Observations in Staphylococcus albus septicemia in mice and men. Arch Intern Med 1958; 102:375388.
18.Ponce de Leon, S, Wenzel, RP: Hospital-acquired bloodstream infections with Staphylococcus epidermidis. Review of 100 cases. Am J Med 1984; 77:639644.
19.Peters, G, Locci, R, Pulverer, G: Adherence and growth of coagulase-negative Staphylococci on surfaces of intravenous catheters. J Infect Dis 1982; 146:479482.
20.Christensen, GD, Simpson, WA, Bisno, AL, et al: Adherence of slime producing strains of Staphylococcus epidermidis to smooth surfaces. Infect Immun 1982; 37:318326.


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