This retrospective study reviewed the medical records of all patients who had nosocomial bacteremia in intensive care units of a medical center in Taipei from 1993 till 2000. There were 685 episodes of bacteremia that developed nosocomially in 596 patients. The average annual crude incidence rate was 3.4%, and the incidence density was 5.4¢X/oo. A total of 816 strains of micro-organisms was isolated; 15.6% of the patients had multiple pathogens. 258 patients died. There were 49.5% Gram-negative bacteria, 24.4% Gram- positives, 9.8% fungi, and 0.9% anaerobes. The most commonly isolated were: Staphylococcus aureus (16.1%) (87.8% of which were methicillin-resistant), Acinetobcter spp. (15.1%), fungi (10.3%), Enterobacter cloacae (6.6%), and coagulase-negative staphylococci (5.8%). Statistical differences (by chi-square test) were present among annual incidences of bacteremias caused by S. aureus, fungi, Serratia spp, and Burkholderia cepacia (P<0.05). The sources of the bacteremia were identified in 48%. The major sources of the infection were: lower respiratory (16.4%), intravenous catheters (8.2%), and urinary tract (5.3%). The highest mortality rate was seen in cases secondary to the urinary tract infection (44.4%). Acinetobacter spp. were the most frequently isolated organisms between 1993 till 1996; whereas Staphylococcus aureus was the most important since 1997. Catheters inserted into patients were independently predictive of the bloodstream infections.
This retrospective study reviewed the medical records of all patients who had nosocomial bacteremia in intensive care units of a medical center in Taipei from 1993 till 2000. There were 685 episodes of bacteremia that developed nosocomially in 596 patients. The average annual crude incidence rate was 3.4%, and the incidence density was 5.4¢X/oo. A total of 816 strains of micro-organisms was isolated; 15.6% of the patients had multiple pathogens. 258 patients died. There were 49.5% Gram-negative bacteria, 24.4% Gram- positives, 9.8% fungi, and 0.9% anaerobes. The most commonly isolated were: Staphylococcus aureus (16.1%) (87.8% of which were methicillin-resistant), Acinetobcter spp. (15.1%), fungi (10.3%), Enterobacter cloacae (6.6%), and coagulase-negative staphylococci (5.8%). Statistical differences (by chi-square test) were present among annual incidences of bacteremias caused by S. aureus, fungi, Serratia spp, and Burkholderia cepacia (P<0.05). The sources of the bacteremia were identified in 48%. The major sources of the infection were: lower respiratory (16.4%), intravenous catheters (8.2%), and urinary tract (5.3%). The highest mortality rate was seen in cases secondary to the urinary tract infection (44.4%). Acinetobacter spp. were the most frequently isolated organisms between 1993 till 1996; whereas Staphylococcus aureus was the most important since 1997. Catheters inserted into patients were independently predictive of the bloodstream infections.