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PubMed2006

[Epidemiological features of community- and nosocomial-acquired bacteremia in the hospitalized elderly patients].

OBJECTIVES: To analyze the epidemiology and to identify associated factors for community- and nosocomial-acquired bacteremia in the elderly (BE). PATIENT AND METHODS: Elderly patients diagnosed of bacteremia were selected. Community- or acquired-bacteremia were defined according to standard criteria. The severity of underlying diseases was classified as non-fatal, ultimately fatal, or rapidly fatal, according to McCabe-Jackson criteria. Multivariate analysis by logistic regression was used to identify associated factors to bacteremia. RESULTS: Two hundred and forty-two cases of BE were selected. The mean age was 72.5 years, 50% occurred in males. One hundred and thirty cases (53.7%) were community-acquired and 112 (46.3%) cases were nosocomial-acquired BE. Most common underlying diseases were diabetes mellitus (30.6%%), chronic obstructive pulmonary disease (25.6%) and neoplasia (24%). Gram-negative bacteria were more frequently isolated in community-acquired BE, while gram-positive cocci were more common in nosocomial-acquired BE. Sources of infection were: vascular (19%), respiratory tract (18.6%), biliary tract (17.8%) and urinary tract (8.3%). The factors associated with nosocomial-acquired BE were (adjusted OR; 95%CI): underlying diseases (5.4; 2.7-10.8), neoplasia (2.5; 1.3-4.9) and vascular origin (2.2; 1.1-4.5). Fifty-two patients died (23.1%). CONCLUSIONS: BE occurs in elderly patients debilitated with well-defined underlying diseases. BE is associated to high mortality.

Aged↗
PubMed2006

Clinical characteristics of group B streptococcus bacteremia in non-pregnant adults.

BACKGROUND AND PURPOSE: Group B streptococcus (GBS) [Streptococcus agalactiae] is an emerging cause of disease in non-pregnant adults with underlying diseases. This retrospective study analyzed 90 episodes of GBS bacteremia in adults occurring over a 4-year period. METHODS: Basic and clinical data were collected by reviewing medical charts of patients. Blood cultures were performed on admission of patients suspected of bacteremia. Presence of underlying diseases, such as liver disease, heart disease, urinary tract disorders, and female-specific cancers, as well as possible portals of entry of infection was analyzed. RESULTS: In 56 episodes (62.2%), patients were aged 60 years or older and 40 (44.4%) episodes occurred in males. Skin and soft tissue were the most common sources of GBS bacteremia (22/90, 24.4%). GBS bacteremia was classified as primary in 50% of the episodes (45 patients). Liver diseases were more common in males, while malignancy was more common in females. Portals of entry with a significant gender predominance included skin and soft tissue in women (p=0.018), bone and joint in women (p=0.016), and urinary tract in men (p=0.042). The overall mortality rate was 18.9% and the attributable mortality rate was 7.8%. CONCLUSIONS: Elderly people and those with underlying diseases are particularly susceptible to GBS infections. Preventive strategies, including GBS vaccine and skin care, are likely to be particularly important in these high-risk groups.

Adult↗
PubMed2006

Causes of community-acquired bacteremia and patterns of antimicrobial resistance in Vientiane, Laos.

There is no published information on the causes of bacteremia in the Lao PDR (Laos). Between 2000 and 2004, 4512 blood culture pairs were taken from patients admitted to Mahosot Hospital, Vientiane, Laos, with suspected community-acquired bacteremia; 483 (10.7%) cultures grew a clinically significant community-acquired organism, most commonly Salmonella enterica serovar typhi (50.9%), Staphylococcus aureus (19.0%), and Escherichia coli (12.4%). S. aureus bacteremia was common among infants (69.2%), while children 1-5 years had a high frequency of typhoid (44%). Multi-drug-resistant S. Typhi was rare (6%). On multiple logistic regression analysis, typhoid was associated with younger age, longer illness, diarrhea, higher admission temperature, and lower peripheral white blood cell count than non-typhoidal bacteremia. Empirical parenteral ampicillin and gentamicin would have some activity against approximately 88% of clinically significant isolates at a cost of US $1.4/day, an important exception being B. pseudomallei. Bacteremic infants in this setting require an anti-staphylococcal antibiotic.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Bacteremia in a community hospital. Review of 78 cases].

We analyze retrospectively all bacteremic episodes seen between January and December, 1987 in our institution. From a total number of blood cultures performed of 897, 145 were positive (16%), and 67 of them considered as contamination (7.5%). There were 78 episodes of bacteremia in 74 patients, 38 males and 36 females. Forty-eight episodes were community-acquired and 30 were nosocomial bacteremia episodes. Aerobic bacteria were isolated in 64 cases, anaerobic bacteria in 9 cases and polymicrobial bacteremia in 5 cases. The most commonly isolated microorganism was S. epidermidis in nosocomial cases and E. coli in community-acquired cases. Predisposing conditions registered were diabetes mellitus in 16 cases (20%), cirrhosis of the liver in 3 (4%), corticosteroid therapy in 7 (9%) and surgical procedures in 19 (24%). Shock was seen in 16 cases (20%), DIC in 8 cases (10%) and ARDS in 5 (6.5%). Appropriate antibiotic treatment was used in 60 episodes (77%). Seventeen patients (22%) died. Prognostic factors identified were: nosocomial bacteremia (p less than 0.05), corticosteroid prior therapy (p less than 0.05), underlying disease UF or RF (p less than 0.0001) and the presence of shock (p less than 0.0001). Mean hospital stay was 20.1 days in bacteremic patients vs. 7.6 days in non bacteremic patients (p less than 0.00001).

Adult↗
PubMed1995

Group A beta-hemolytic streptococcal bacteremia: historical overview, changing incidence, and recent association with varicella.

OBJECTIVE: To quantitate the increase in invasive group A beta-hemolytic streptococcal (GABHS) infections and to define a possible association between GABHS bacteremia and primary varicella zoster virus (VZV) infections. METHODS: This was a retrospective chart review conducted at Children's Hospital. Participants were patients with documented GABHS bacteremia occurring from January 1977 through December 1993. MEASUREMENTS/MAIN RESULTS: We identified 63 episodes of GABHS bacteremia in 62 patients. From 1977 to 1992, a mean of 3.2 +/- 2 cases occurred per year (range, 0 to 6), increasing by a factor of 3 (10 cases) in 1993. The median age was 4 years (range, 1 day to 20 years; mean, 8 years +/- 3 months); 36 were male; five children were immunocompromised. One child was dead on arrival and one had a cardiac arrest during evaluation in the emergency department. Primary sites of infection (oropharynx, skin, or middle ear) were identified in 40 (75%) of the cases; in addition, 10 cases occurred in patients with primary VZV. From 1977 to 1992, we identified five VZV-associated cases; an average of 7 +/- 11.5% of the patients with GABHS had concurrent VZV infection annually, with no more than one case per year. In 1993, 50% of the 10 new GABHS cases were in children with VZV infection (P = .003, Fisher's exact test). The diagnosis of invasive GABHS infection in patients with VZV was not readily recognized, requiring a median of two (range, one to four) physician visits before admission and the administration of antibiotics. All 10 children were diagnosed on the fourth or fifth day of the exanthem and were febrile (39.6 +/- 1.1 degrees C, range, 38.3 to 40.8 degrees C), with a mean white blood cell count (WBC) of 11,500 +/- 8,400/mm3 (8 of 10 cases had a WBC less than 15,000/mm3). None of the five VZV-associated cases in 1993 had signs of cutaneous bacterial superinfection; among these were two cases of streptococcal toxic shock syndrome (one death), one case of osteomyelitis, and two cases of occult bacteremia. Of the five VZV-associated cases before 1993, one patient was diagnosed with supraglottitis, one with septic arthritis, one with orbital cellulitis, and two solely with impetiginized or cellulitic lesions. CONCLUSIONS: We found that the incidence of invasive GABHS infections has risen dramatically, increasing by a factor of 3 over the past year. In 1993, 50% of new cases of invasive GABHS disease were associated with VZV infection. Invasive GABHS should be considered in children with VZV who manifest fever on or beyond the fourth day of the exanthem. The absence of an elevated WBC and impetiginized or cellulitic lesions should not eliminate this diagnosis from consideration.

Bacteremia↗
PubMed1995

[Nasal carriage of Staphylococcus aureus: prevalence in a hemodialysis center and effect on bacteremia].

We evaluated nasal carriage of Staphylococcus aureus (S. aureus) in 114 hemodialysis patients by performing two nasal swab cultures at a one month interval. The incidence of bacteremia was then followed for one year. Other factors associated with infections in hemodialysis patients, such as diabetes, central venous catheter, and high serum ferritin levels were also evaluated. Nasal carriage of S. aureus was present in 29.8% of patients (34/114). Six S. aureus bacteremia occurred in 6 patients. This represents an annual incidence of 0.058 bacteremia/patient-year. The incidence of bacteremia was higher in patients with S. aureus nasal carriage (0.0945) than in patients without (0.0417), but the difference was not significant. The relative risk (RR) was 2.35. On the contrary, bacteremia were significantly more frequent in patients with diabetes (RR = 11.41; p = 0.004) or in patients with central venous catheter (RR = 14.29; p = 0.002). In conclusion, in our population, diabetes and central venous catheter are more significant risk factors of bacteriemia than S. aureus nasal carriage.

Bacteremia↗
PubMed1994

Big-endothelin release in baboon bacteremia is partially TNF dependent.

Big-endothelin (big-ET) is one of the endothelium-derived vasoactive substances that plays an important role in regulating the vascular tone. Because the role of this agent in bacteremia remains unknown, we investigated whether bacteremia induces the release of big-ET in a subhuman primate model and whether tumor necrosis factor (TNF) is an important mediator of big-ET release. To study this, we infused 8 male baboons (17 to 19 kg body weight) intravenously for 2 hours with Escherichia coli (5 x 10(8) CFU/kg) and observed them for 72 hours. Plasma was obtained at various intervals and assayed for big-ET by using immunoassay. Four bacteremic animals given vehicle only showed a peak big-ET plasma concentration of 15.1 +/- 4.6 fmol/ml at 10 hours, as compared with a baseline concentration of 0.9 +/- 0.5 fmol/ml. Administration of anti-TNF monoclonal antibodies (CB6, 15 mg/kg) 2 hours before E. coli infusion in additional animals prevented the rise in plasma TNF levels (5.7 +/- 2.5 ng/ml versus nondetectable) and significantly (p < 0.01) attenuated the release of big-ET. Hemodynamic measurements revealed the typical pattern of sepsis, with generally more stable circulatory conditions in the anti-TNF-treated animals. Moreover, the mortality rate decreased from 100% to 0% with anti-TNF treatment. These studies, therefore, lead us to conclude that TNF, directly or indirectly through another mediator, plays an important role in the endothelin production/release during bacteremia and that neutralization of circulating TNF appears to be beneficial for improving the survival after bacteremia.

Animals↗
PubMedDate not supplied

Negative catheter-tip culture and diagnosis of catheter-related bacteremia.

The accuracy of paired quantitative blood cultures (PQtBCs) collected in pediatric Isolator 1.5-ml tubes compared to central venous catheter (CVC) segment cultures (hub and tip) to diagnose catheter-related bacteremia (CRB) was evaluated in 58 bacteremic adult patients. The second aim of this study was to state precisely whether the tip or the hub (or both) of the infected device was the source of the bacteremia in case of significant results of PQtBC. Fifty-eight bacteremic patients with suspected CRB entered the study. In 52 patients, the diagnosis was obtained before CVC removal by PQtBC and was confirmed by CVC segment cultures: CRB in 30 patients, non-catheter-related bacteremia in 22 patients. Six patients had CRB not found by PQtBC. 1) PQtBC is 83% sensitive, 100% specific (negative predictive values 78%, positive predictive values 100%). 2) Sixteen bacteremic patients had authentic hub-related bacteremia (positive hub culture associated with negative tip cultures). When CRB is suspected in bacteremic patients, a negative tip culture cannot exclude the diagnosis of CRB. In all cases, CVC tip culture must be associated either with PQtBC or with hub cultures.

Adolescent↗
PubMed1994

Reduction of fever and streptococcal bacteremia in granulocytopenic patients with cancer. A trial of oral penicillin V or placebo combined with pefloxacin. International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer.

OBJECTIVE: To determine the effect of oral penicillin V combined with a fluoroquinolone (pefloxacin) on the occurrence of fever and streptococcal and other gram-positive coccal bacteremic infections in granulocytopenic patients with cancer. DESIGN: Prospective randomized double-blinded placebo-controlled prophylactic trial. SETTING: Inpatient setting in multiple cooperating cancer centers. SUBJECTS: Convenience sample with a total of 551 granulocytopenic patients, 95% of whom had leukemia or underwent bone marrow transplantation. INTERVENTIONS: Penicillin V (500 mg twice a day) vs placebo given in combination with oral pefloxacin (400 mg twice a day). MAIN OUTCOME MEASURES: Occurrence of fever and/or infection. RESULTS: Fever or infection (without fever) developed in 190 (71%) of 268 evaluable patients in the penicillin arm compared with 213 (80%) of 268 evaluable patients in the placebo arm (P = .03; 95% confidence interval [CI] for the difference, -16% to -1%). Bacteremia occurred in 58 (22%) of 268 placebo-treated patients and in 38 (14%) of 268 penicillin-treated patients (P = .03; 95% CI for the difference, -14% to -1%), primarily due to a reduction in streptococcal bacteremic episodes that occurred in 14 penicillin-treated patients (5%) and in 27 placebo-treated patients (10%) (P = .05; 95% CI for the difference, -9% to -0.3%). Gram-negative rod bacteremias occurred in only two patients (1%) and in five patients (2%), respectively. Logistic regression analysis also supported the treatment effect on the development of bacteremia. CONCLUSIONS: These results demonstrate that the addition of penicillin V to fluoroquinolone prophylaxis in granulocytopenic patients with cancer effectively reduces febrile episodes and the incidence of bacteremia, especially that due to streptococcal species.

Administration, Oral↗
PubMedDate not supplied

[Pediatric nosocomial bacteremia. Potential usefulness of culturing infusion liquids].

Hospital-acquired bacteremia is a common cause of morbidity and mortality, mainly in pediatric units. In a 25 month retrospective study, we analyzed the blood cultures from the Hospital General Regional of the city of Leon, Guanajuato State, Mexico, in order to establish the causal agents of nosocomial bacteremia and infer some associations with contaminated intravenous infusion fluids. In addition we performed a two month study to culture the flasks and intravenous tubing used in our infusions. Five hundred and fifty one blood cultures drawn from August 1990 to September 1992 were analyzed. A total of 135 (24.5%) were positive, most of them (51.8%) with strains of the Klebsielleae tribe (SKT) (Klebsiella, Enterobacter, Serratia). The global incidence of bacteremia in the two year period was 4.3%. In the infusion study, 230 intravenous fluids were cultured, with 68 isolates (30%) most from the SKT tribe. A final consideration is made on the role that inadequate management of intravenous liquids could play in the development of endemic and epidemic nosocomial bacteremia in our hospital, and the eventual utility of making cultures of the i.v. liquids.

Bacteremia↗
PubMed1994

[Bacteremia caused by anaerobes: analysis of 131 episodes].

BACKGROUND: Despite the efficacy of modern antimicrobials bacteremia by anaerobes (AB) continues to present a high mortality rate. The aim of this study was to determine the relative frequency and clinical significance of isolations of anaerobic bacteria in blood cultures and to know the prognostic factors of AB. METHODS: From total of 231 patients observed over a period of six and a half years in the Fundación Jiménez Díaz, 131 episodes of AB were retrospectively analyzed with special attention being given to microbiologic, epidemiologic and clinical factors. RESULTS: The relative frequency of AB was 7.5%. Clinical significance was found in 86 out of the 131 episodes (66%). The isolation of Bacteroides spp. was clinically significant in 89% while Clostridium spp. was so only in 33% (p < 0.001). Mortality related with AB was 32%. The following factors were considered related to bad prognosis statistical analysis (p < 0.05): admission to medical areas, rapid and finally fatal underlying disease, presence of septic shock, renal failure, inappropriate antimicrobial treatment and the absence of drainage for the septic foci. CONCLUSIONS: Anaerobic bacteremia remains an important cause of bacteremia and carries a high mortality rate. Two thirds of the episodes of anaerobic bacteremia are deemed to be clinically significant. Correct antimicrobian treatment and surgical drainage of any septic foci significantly improves prognosis.

Adolescent↗
PubMed1993

Microvascular vasoconstriction and mucosal hypoperfusion of the rat small intestine during bacteremia.

Our previous studies have demonstrated that bacteremia induces vasoconstriction and hypoperfusion of the small intestinal microcirculation. The present study used time-transit doppler flowmetry, intravital microscopy, and laser doppler fluximetry to measure superior mesenteric artery (SMA) blood flow, intestinal microvascular blood flow, and mucosal perfusion. The aim of this study was to determine the relative importance of the intestinal macro- and microcirculations in the development of mucosal hypoperfusion. Animals were infused with 5 x 10(8) colony-forming units of Escherichia coli/100 g body weight or saline as control. Bacteremia induced a normotensive, normodynamic state. SMA blood flow was unaffected by bacteremia, but arteriolar vasoconstriction (approximately -30%) and microvascular hypoperfusion (approximately -70%) occurred. Mucosal perfusion decreased by 40% from baseline, and was temporally correlated with microvascular hypoperfusion. From these data, we conclude that the microcirculation has a central role in the development of mucosal hypoperfusion during bacteremia.

Animals↗
PubMedDate not supplied

Bacteremia following postoperative choledochofiberscopy--a prospective study.

BACKGROUND/AIMS: The following investigation was undertaken in order to determine the frequency and clinical consequences of bacteremia after postoperative choledochofiberscopy. MATERIALS AND METHODS: A total of 100 patients were prospectively studied for the frequencies of bacteremia after postoperative choledochoscopy. RESULTS: Positive blood cultures were obtained in 15%; at 5-minutes period in seven patients, at 15-minutes in eight patients and at 30-minutes in two patients. There were two patients with positive cultures at 5 minutes and 10 minutes periods. All the bacteria species cultured were aerobes. Enterococcus, E-coli and Klebsilla were the most commonly cultured bacteria. The frequencies of occurrence of bacteremia seemed not be influenced by the existence of residual stones, session of the endoscopy and duration of the procedure. Six of the 15 bacteremic patients developed cholangitis within 24 hours of the procedure. They all recovered with antibiotic treatment. Patients with negative blood cultures were not found with cholangitic symptoms after the postoperative choledochoscopy. CONCLUSIONS: The results of our study indicated that fifteen percent of patients undergoing postoperative choledochofiberscopy are associated with bacteremia. We believe that with adequate aseptic preparation and meticulous, gentle manipulation, routine prophylactic antibiotics may not be necessary for postoperative choledochoscopy in selected conditions.

Bacteremia↗
PubMed1996

Bacteremia in cancer patients with solid tumors undergoing chemotherapy versus surgery: risk factors, etiology and outcome in 276 patients.

Risk factors, etiology, symptomatology and outcome of bacteremia in 276 patients with solid tumors were evaluated. A group of 78 patients with solid tumors and surgical therapy was compared with 172 patients with solid tumors but treated solely by chemotherapy. The most frequently observed risk factors of bacteremia in patients after surgery were the vascular and urinary catheter insertions, wound as source of bacteremia, staphylococci, enterococci and Enterobacteriaceae as etiologic agents. Comparing the group of therapeutically treated patients with solid tumors, with the group of those treated only by chemotherapy, a statistically significant difference in risk factors between both groups was observed only in the incidence of catheter insertion (more frequently in surgically treated patients), neutropenia (more frequently in those treated by chemotherapy). Wound as source of bacteremia was more frequently observed in those after surgery. Enterobacteriaceae and enterococci were significantly more frequently observed in patients with solid tumors treated by surgery. Surprisingly, patients after surgery the mortality due to septic shock was lower in (6.4% vs 16.9%, p < 0.03) than in the control group of patients with solid tumors treated solely by chemotherapy. (Tab. 1, Ref. 5.).

Antineoplastic Agents↗
PubMed1997

Relapsing bacteremia after blood transmission of Bartonella henselae to cats.

OBJECTIVES: To determine persistence of bacteremia, pathogenicity, and immunoglobulin kinetics after blood transmission of Bartonella henselae in cats. ANIMALS: 18 specific-pathogen-free (SPF) cats (16 weeks old) received blood or urine from 4 adult cats (2 SPF, 2 naturally infected with B henselae). PROCEDURE: SPF cats were inoculated with blood IV (n = 4), blood IM (n = 4), or urine sediment IM (n = 4) from 2 bacteremic cats (donors A and B). Control cats (2/route) received inoculum from culture-negative, seronegative SPF cats (donors C and D). RESULTS: 6 cats (5 blood, 1 urine) were transiently febrile during the 213-day observation period. Two bacteremic cats developed CNS abnormalities. Transient anemia was the only hematologic abnormality. Bacteremia was induced in 7 of 8 blood recipients by postinoculation day (PID) 11. Urine recipients (n = 6) did not become bacteremic or seroconvert by PID 108, but when challenge exposed IV with blood, 4 of 6 became infected. All infected cats developed relapsing bacteremia. Initially, colony counts for donor-A recipients were 10(3) greater than those for donor-B recipients; however, during relapses, counts were similar. Polymerase chain reaction-restriction fragment length polymorphism analysis of 16S rRNA gene and the intergenic spacer region revealed no differences among isolates derived from recipient cats. Bartonella henselae-specific antibodies were detected between PID 15 and 18 in donor-A, compared with PID 46 and 181 in donor-B recipients. The peak geometric mean titer of donor-A recipients was 1,448, versus 406 for donor-B recipients. CONCLUSIONS AND CLINICAL RELEVANCE: Blood transmission of B henselae induced subtle clinical abnormalities; the biological behavior of the 2 donor strains differed; and relapsing bacteremia can persist in conjunction with variably high antibody titers.

Animals↗
PubMed1997

Burkholderia cepacia bacteremia: a retrospective analysis of 70 episodes.

Burkholderia cepacia, a widespread gram-negative environmental bacillus associated with nosocomial infections, is considered to be of relatively low virulence and rarely to cause invasive disease. We retrospectively analyzed the risk factors, clinical manifestations, antimicrobial susceptibilities, and prognostic factors of B. cepacia bacteremia cases. From 1982 through 1995, 70 episodes of bacteremia due to B. cepacia occurred in 52 patients at the National Taiwan University Hospital. The overall case fatality rate was 11%. Sixty-four episodes were nosocomial infections. The common predisposing conditions were stay in an intensive care unit (61%) and invasive procedures, including urinary catheter (54%), intravenous catheter (70%), and intubation (57%). Three episodes involved polymicrobial bacteremia. In 41 episodes in which the infectious focus was identified, the respiratory tract was the most common portal of entry (17/41) followed by intravascular catheters (11/41). Most strains tested were susceptible to ceftazidime (95%), piperacillin (93%), minocycline (85%), and cefotaxime (82%); but most were resistant to aminoglycosides, tetracycline, carbenicillin, and ticarcillin. For empirical therapy of B. cepacia bacteremia, ceftazidime or piperacillin should be the drug of choice.

Adolescent↗
PubMedDate not supplied

Bacteremia of dental origin and antimicrobial sensitivity following oral surgical procedures in children.

METHODS: The prevalence and intensity of bacteremia of dental origin were examined in 207 children divided into four groups: a baseline with no surgical intervention (group I), after a single tooth extraction (group II), multiple tooth extraction (group III), and mucoperiosteal flap elevation (group IV). The bacterial isolates were grown using a broth culture (Bactec) and lysis centrifugation (Paediatric Isolator) techniques. Dental plaque deposits, gingivitis, spontaneous gingival bleeding and the presence/absence of a dental abscess were recorded and their relationship to bacteremia assessed. RESULTS: The broth culture was positive for group I 11% of the time, group II for 43%, group III for 54%, and group IV for 43%. The Paediatric Isolator system was found to be a poor method for detecting bacteremia, having only one quarter the sensitivity of the broth culture technique. When organisms were isolated, the intensity of bacteremia ranged from 1 to 3400 colony forming units per milliliter (cfu/mL). Bacterial isolates were susceptible to most of the antibiotics recommended for antibiotic prophylaxis, but erythromycin, gentamycin, penicillin G, and teicoplanin were only 80% (or less) effective in their efficacy while chlorhexidine, amoxicillin, clindamycin, and vancomycin were between 92 and 100% effective. CONCLUSIONS: The antibiotics commonly used for an oral and/or parenteral prophylaxis are likely to be effective on at least 80% of occasions with most of them effective on 100% of occasions.

Amoxicillin↗
PubMed1997

[Changes in patterns and resistances of bacteria from 731 patients with bacteremia in 11 years].

OBJECTIVE: To study the changes in patterns and resistances of bacteria from patients with bacteremia in 11 years. METHODS: Diffusion tests were used to measure the antibiotic sensitivity of bacteria isolated from the patients with bacteremia. RESULTS: The proportion of staphylococcus epidermidis in bacteremia increased significantly. The proportion of methicillin-resistant Staphylococcus aureus (MRSA) in bacteremia caused by staphyiococcus increased markedly. Resistance of MRSA and methlcillin-sensitive staphylococcus aureus (MSSA) to penicillin, and gentamycin increased significantly. Compared 1986-1990, with 1991-1996, the resistance of S. epidermidis to penicillin, erythromycin and methicillin increased markedly, so did resistance of pseudomonas aeruginosa to carbenicillin, and piperacillin, resistance of E. coli to gentamycin and cefoperazone, resistance of klebsiella to ampicillin and carbenicillin. The resistance of enterobacteriaceae which induced beta-lactamase to the first to the third generation of cephalosporins was relatively high. CONCLUSION: The resistance of bacteria to the commonly used antibiotics was produced in various degrees.

Adolescent↗