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PubMed1993

The value of surveillance cultures on neonatal intensive care units.

Nosocomial infections on neonatal intensive care units (NICUs) have been a recognized cause for concern for many years. It is the endeavour of the doctors caring for these children to identify and treat such infections as early as possible in an effort to reduce morbidity and mortality to a minimum. A high percentage of babies on NICU become colonized with Gram-negative bacilli (GNB) with increasing length of stay on the unit. Those babies that remain on NICU for prolonged periods, and who become colonized, tend to be the most premature and sickest infants, and therefore are most at risk of becoming septic. The use of surface cultures in predicting the organisms responsible for sepsis is inefficient and not cost-effective. There is some evidence that endotracheal aspirate cultures in ventilated neonates may be helpful in identifying the pathogens responsible for perinatal pneumonia. Most NICUs have an antibiotic policy for the blind treatment of sepsis which covers the most common organisms responsible, and it is likely that antimicrobial treatment is rarely altered as a result of pathogens isolated from surface cultures. Again this makes the collection of surface cultures a wasteful and costly use of resources. In the light of the increasing incidence of Gram-positive infections on NICUs, antibiotic policies may have to be altered to accommodate these pathogens. As well as continued attention to good infection control measures, it remains with the clinician to be alert to the onset of sepsis in neonates and institute broad spectrum antimicrobial cover after collecting blood and cerebrospinal fluid cultures as indicated.(ABSTRACT TRUNCATED AT 250 WORDS)

Cells, Cultured↗
PubMed1997

Reports on surveillance of antimicrobial resistance in individual countries.

In preparation for the meeting of the World Health Organization Working Group on Monitoring and Management of Bacterial Resistance to Antimicrobial Agents, representatives of 10 countries were asked to provide brief reports on the status of surveillance in their countries. Some gave extensive information on the methods used to test susceptibility of nosocomial pathogens to a variety of antibiotics; some described in detail the network of reference laboratories available to hospitals and individual clinicians for monitoring, identifying, and testing infectious agents; others chose to describe how their countries deal with the resistance of the most frequently isolated pathogen to a commonly used drug. The following summary of these reports shows the broad range of problems encountered and solutions undertaken by these 10 countries in dealing with the increasingly alarming problem of bacterial resistance to antimicrobial agents.

Algeria↗
PubMed2001

Blood culture confirmed typhoid fever in a provincial hospital in the Philippines.

Epidemiological features of blood culture confirmed typhoid fever and antibiotic sensitivity of isolated Salmonella typhi strains were investigated in Bohol Province in Central Philippines from where no earlier information of these was avialable. Typhoid fever is endemic elsewhere in the Philippines (eg Metropolitan Manila and surroundings) where also multidrug resistant S. typhi strains have been detected. A laboratory for surveillance of invasive bacterial infections was established in a tertiary care government hospital, in Bohol, Central Philippines, in 1994. Patients with suspected typhoid fever or other serious infection were managed and blood cultures from them were taken according to clinicians' judgment. Blood cultures were processed and the isolated bacteria identified using generally accepted methods. S. typhi and other Salmonella isolates were identified using commercial antisera. Patient data were collected from hospital records. Of a total of 4,699 blood cultures done during a period of 3 3/4 years, 1,530 (32%) were requested for suspected typhoid fever. S. typhi was the most common pathogen isolated from 422 patients (8.9%), followed by S. paratyphi A from 55 patients (1%). Most patients were young adults (43%) and school age children (28%). Male:female ratio was 1.5:1. Among the 422 patients, there were 9 (2%) deaths due to typhoid fever, all with complications. All S. typhi isolates were sensitive to chloramphenicol, cotrimoxazole, and ampicillin. Our observation on blood culture confirmed typhoid fever demonstrates its importance as a major infectious disease in Bohol and gives a sound basis for treatment of typhoid patients and for further clinical and epidemiologic studies of typhoid fever and for following antibiotic sensitivity of S. typhi in Bohol and elsewhere in the Philippines.

Adolescent↗
PubMed2004

Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset.

Neonatal sepsis is a major cause of death in newborns despite sophisticated neonatal intensive care. This retrospective study reviewed the clinical characteristics of cases of culture-proven sepsis in a neonatal intensive care unit from January 1992 to December 2001. Patients were divided into those with onset of sepsis in the first 7 days of life (early-onset group) and those with onset after the seventh day of life (late-onset group). A total of 270 cases with 325 episodes of sepsis and 353 isolated pathogens were identified and included in the study. The male-to-female ratio was 1.4. The majority of cases of sepsis occurred in low birth weight (75.9%) and premature babies (76.7%). Late onset occurred in 71.9% of cases. Patients with late onset had a lower mortality rate than those with early onset (11.3% vs 28.9%). Coagulase-negative staphylococci (20.1%) was the most common organism isolated, but infection with Pseudomonas aeruginosa was associated with the highest morality rate (55.0%). Late-onset sepsis was significantly more common in very low birth weight and premature infants. The most frequently encountered pathogens in the early-onset group were group B streptococci (GBS) and Escherichia coli, while in the late-onset group, the organisms were coagulase-negative staphylococci and Enterobacteriaceae, including E. coli, Klebsiella pneumoniae, and Acinetobacter baumannii. GBS infection resulted in the highest mortality when the onset of sepsis was within the first 24 hours of life.

Age Factors↗
PubMed2006

Bacteremia in children at a regional hospital in Trinidad.

OBJECTIVE: The objective of this study was to provide a Trinidadian perspective on pediatric community-acquired and hospital-acquired bacteremia via the documentation of common etiologic agents, antimicrobial profiles of the isolated pathogens, and patient outcome. METHODS: This was a six-year retrospective study of children with bacteremia admitted to the pediatric wards of the San Fernando General Hospital, Trinidad. RESULTS: Seven hundred and four episodes of pediatric bacteremia were reviewed during the six-year study period. The predominant isolate was Staphylococcus aureus (23.9%), followed by Pseudomonas aeruginosa (15.5%), Klebsiella pneumoniae (12.5%), and Enterobacter spp (11.1%). The remaining isolates each accounted for less than 10% of total isolates. The mortality rate was highest for P. aeruginosa (39.4%), Streptococcus pneumoniae (22.5%), and Escherichia coli (19.2%). Of the six cases due to Neisseria meningitidis, only two survived. The overall mortality rate for the study period was 15.1%, but varied considerably according to age. All deaths due to P. aeruginosa and E. coli occurred in neonates. Almost 90% and about half of all S. aureus were resistant to ampicillin and erythromycin, respectively; nineteen (11.3%) were methicillin-resistant. More than 95% of K. pneumoniae and more than 87% of Haemophilus influenzae were resistant to ampicillin. Group B streptococci were fully susceptible to ampicillin and amoxicillin-clavulanic acid, but showed >90% and >70% resistance to tetracycline and trimethoprim-sulfamethoxazole, respectively. Of the 40 strains of S. pneumoniae isolated, 10.0% had a minimum inhibitory concentration (MIC) >or=4 microg/mL (resistance) and 12.5% had a MIC=2.0 microg/mL (intermediate resistance) to ceftriaxone, while 7.5% showed intermediate resistance (MIC between 0.12 and 1 microg/mL) and 25.0% showed resistance (MIC >or=2 microg/mL) to penicillin. CONCLUSION: The bacteremia rate was found to be 8.4% among hospitalized children suspected of having sepsis and from whom a blood culture was positive. Bacteremia was also associated with a high mortality rate of 15.1%. An unusually high level of bacteremia with Gram-negative enteric bacteria was seen, which might indicate cross infection and reflect a breakdown in infection control measures. Relatively high-level resistance of S. pneumoniae to penicillin and ceftriaxone was not seen, even though the overall prevalence of resistance to other antibiotics among other pathogens was relatively low. The drugs that showed the greatest efficacy were imipenem, gentamicin, ciprofloxacin, and the cephalosporins ceftazidime and ceftriaxone.

Bacteremia↗
PubMed1999

Topical ofloxacin treatment of otorrhea in children with tympanostomy tubes.

OBJECTIVE: To determine the safety and efficacy of ofloxacin otic solution in the treatment of acute otorrhea in children with tympanostomy tubes. DESIGN: Multicenter study with an open-label, prospective ofloxacin arm and retrospective historical and current practice arms. SETTING: Ear, nose, and throat pediatric and general practice clinics and office-based practices. SUBJECTS: Children younger than 12 years with acute purulent otorrhea of presumed bacterial origin and tympanostomy tubes. INTERVENTION: Instillation of 0.3% ofloxacin, 0.25 mL, twice daily for 10 days in the prospective arm; review of medical records in the retrospective arms. MAIN OUTCOME MEASURES: The primary index of clinical efficacy was absence (cure) or presence (failure) of otorrhea at 10 to 14 days after therapy. The primary index of microbiologic efficacy (in the ofloxacin arm only) was eradication of pathogens isolated at baseline. Safety was evaluated in the ofloxacin arm only. RESULTS: Significantly more clinically evaluable ofloxacin-treated subjects were cured (84.4%; 119/141) than were historical practice subjects (64.2%; 140/218) (P< or =.001) or current practice subjects (70%; 33/47) (P< or =.03). All baseline pathogens were eradicated in 103 (96.3%) of 107 microbiologically evaluable ofloxacin subjects. Adverse events considered "possibly" or "probably" treatment related occurred in 29 (12.8%) of 226 ofloxacin-treated subjects. CONCLUSION: Ofloxacin is safe and significantly more effective than treatments used in historical or current practice for acute purulent otorrhea in children with tympanostomy tubes.

Administration, Topical↗
PubMed1997

Patterns of clinical mastitis manifestations in Danish organic dairy herds.

Danish organic dairy production is characterized by a low input of antibiotics for udder treatment and a high input of other mastitis control procedures. A study was conducted in 14 organic dairy herds with the objectives of obtaining a comprehensive description of clinical mastitis cases and identifying characteristic patterns in these results. Clinical signs, inflammatory reactions and microbiological identifications were obtained from 367 cases of clinical mastitis occurring over 18 months. Cow characteristics and preincident values such as milk yield and somatic cell count were obtained for each cow. Signs of previous udder inflammation were present in two-thirds of the clinical mastitis cases. Severe local inflammatory reactions were found in 21% of the cases and some indication of generalized signs such as fever and reduced appetite were found in 35% of the cases. Logistic regression analyses were performed based on the results of an initial (exploratory) multiple correspondence analysis. Coliform mastitis (6% of the cases) was rarely preceded by pathogen isolation or inflammatory reactions in the same quarter. Coliform mastitis cases usually occurred in one quarter only. Escherichia coli infections were typically (truly) acute cases. Bacteriologically negative mastitis (20% of the cases) showed strong similarities with clinical coliform mastitis. Staphylococcus aureus cases (18% of the cases) occurred most frequently in late lactation or around drying-off. Prior isolation of Staph. aureus and slight decreases in milk yield were two factors that interacted but both were strongly and positively related to clinical Staph. aureus. Staph. aureus mastitis typically had a subclinical debut, and increasing degrees and duration of inflammation decreased shedding of this pathogen. Streptococcus dysgalactiae (9% of the cases) mastitis was typically persistent virulent and manifest in periods of lower cow resistance. More patterns of subclinical and clinical Str. uberis mastitis (23% of the cases) seemed to be present.

Animals↗
PubMed1987

Campylobacter hyointestinalis associated with human gastrointestinal disease in the United States.

Campylobacter hyointestinalis was isolated from stool specimens of four persons, all of whom were experiencing nonbloody, watery diarrhea. The youngest (8 months of age) and the oldest (79 years of age) individuals were females, and the other two were homosexual men. C. hyointestinalis was the only clinically significant pathogen isolated from stool specimens for three of the individuals. In case 3 (involving a 37-year-old homosexual man), Entamoeba histolytica and Shigella sonnei were also present in the stool. The identification of all C. hyointestinalis strains was made biochemically and confirmed by DNA hybridization. This study documented the isolation of C. hyointestinalis from four patients with diarrhea, and our findings suggest that the clinical significance of Campylobacter species must be expanded to include C. hyointestinalis as a potential cause of human gastrointestinal disease.

Adult↗
PubMed1999

Early infections in patients undergoing bone marrow or blood stem cell transplantation--a 7 year single centre investigation of 409 cases.

Infections are a major cause of morbidity and mortality in patients undergoing high-dose therapy and subsequent autologous or allogeneic haemopoietic stem cell transplantation, despite the change from topical to systemic anti-infection prophylaxis and the introduction of growth factors and new antimicrobial drugs. We report our single centre experience with data from 409 patients treated at our unit from its opening in 1990 until May 1997. Three hundred and seventy-eight patients were transplanted for the first time, 12 patients were retransplanted or boosted and 19 patients were readmitted for miscellaneous reasons. 245 patients were allografted and 157 autografted. Antimicrobial prophylaxis was mainly quinolones, fluconazole plus amphotericin-B orally, aciclovir, and TMP/SMX or pentamidine. Three hundred and nineteen (78%) developed fever of significantly longer duration in the allogeneic setting with anti-CMV seropositivity. The most frequent infection was fever of unknown origin (50.6%), followed by septicaemia (12.5%) and pneumonia (11.0%). Pathogens isolated in 24.6% of the infections were mostly gram-positive bacteria (57.9%), followed by non-fermenting rods (11.2%), Aspergillus spp. and Candida spp. (10.3%, each). Cumulative response rate to antimicrobial therapy was 66.9%. Infections were responsible for 62.5% (25/40) of deaths after transplantation. Predominant pathogens were Aspergillus spp. (11), Candida spp. (four), and Pseudomonas spp. (three). None of the patients died from gram-positive bacterial infection. The risk of dying from infection was 11.2% after allografting and 0.8% after autotransplantation. Infections remain a major risk for early death after allogeneic transplantation of haemopoietic stem cells. Infection with gram-negative bacteria can be prevented by quinolone prophylaxis. Predominant pathogens are Aspergillus spp. Candida spp. and nonfermenting rods. Systemic infection with these pathogens is associated with a poor prognosis. Antimycotic prophylaxis and the therapy must be improved.

Adolescent↗
PubMed2002

Properties of the surface envelope glycoprotein associated with virulence of simian-human immunodeficiency virus SHIV(SF33A) molecular clones.

In vivo adaptation of simian-human immunodeficiency virus (SHIV) clone SHIV(SF33) resulted in the emergence of pathogenic isolate SHIV(SF33A), which caused a rapid and severe CD4(+) T-cell depletion when inoculated into rhesus macaques. Two molecular clones generated by inserting the env V1-to-V5 region amplified from SHIV(SF33A)-infected animals into the parental SHIV(SF33) genome retained a pathogenic phenotype. The gp120 envelope glycoproteins of pathogenic clones SHIV(SF33A2) and SHIV(SF33A5) conferred a threefold increase in viral entry and fusogenicity compared to the parental glycoprotein. Changes in gp120 were also responsible for a higher replication capacity and cytopathicity in primary CD4(+) T-cell cultures. Last, gp120 carried the determinants of SHIV(SF33A) neutralization resistance. Thus, changes in SHIV(SF33A) gp120 produced a set of properties that could account for the pathogenic phenotype observed in vivo. Measurement of antibody binding to SHIV(SF33A) viral particles revealed an increased exposure of the CD4-induced epitope recognized by the 17b monoclonal antibody in a region that was shown to contribute to coreceptor binding. Exposure of this epitope occurred in the absence of CD4 binding, suggesting that the envelope glycoprotein of pathogenic SHIV(SF33A) clones folded in a conformation that was primed for interaction with CXCR4 or for the subsequent step of fusion.

Amino Acid Sequence↗
PubMed1978

Incidence of infections with Salmonella enteritidis serotypes in Black and Indian children. A 16-year survey.

A 16-year survey (1960--1975) of Salmonella infections other than typhoid fever in Black and Indian children admitted to King Edward VIII Hospital, Durban, is reported. The 3,393 patients yielded 3,688 Salmonella enteritidis serotypes, mainly typhimurium, johannesburg/duval, manhattan, enteritidis, and senftenberg. Organisms were isolated from one or more of the following: stool, urine, blood, cerebrospinal fluid, liver, sputum, subcutaneous tissue, ear and bone. Patients' ages varied from 1 day to 12 years, with a median age of 8 months. The high incidence of malnutrition, other debilitating diseases and multiple pathogens isolated from many of the patients precluded firm decisions as to the role played by most salmonellae as contributory factors or causes of death.

Black or African American↗
PubMed1986

Randomized, comparative trial of imipenem/cilastatin and moxalactam in the treatment of serious obstetric and gynecologic infections.

Thirty-four patients with pelvic inflammatory disease, postoperative, postabortal and postpartum infections were randomized to intravenous therapy with either 500 milligrams of imipenem and cilastatin sodium every six hours or 2 grams of moxalactam every eight hours for a minimum of four days. One patient in the moxalactam group was nonevaluable because of protocol noncompliance; three more patients had no bacteriologic pathogen isolated (two in the moxalactam group and one patient in the imipenem/cilastatin group). The two groups were similar with respect to age, diagnosis, etiologic agents and duration of therapy. Of the 17 evaluable patients in the imipenem/cilastatin group, all were complete clinical cures. Three patients in the imipenem/cilastatin group had persistence of at least one bacteriologic pathogen despite clinical cure and apparent laboratory evidence of susceptibility. Of the 13 evaluable patients in the moxalactam group, eight were complete clinical cures. Two more patients in that group were clinically improved enough to be discharged on oral antibiotics. There were three clinical failures in the moxalactam group, all of whom had group D streptococcus resistant to moxalactam. An additional three patients in the moxalactam group had other resistant organisms isolated despite clinical cure. Both drugs were well tolerated and no serious complications or side effects occurred in either group. Despite small numbers, our data suggest that imipenem and cilastatin is a more appropriate agent for initial treatment of obstetric and gynecologic infections than moxalactam.

Acute Disease↗
PubMed2003

Multi-locus sequence typing: a tool for global epidemiology.

The characterization of pathogenic isolates plays a pivotal role in the epidemiology of infectious diseases, generating the information necessary for identifying, tracking, and intervening against disease outbreaks. In 1998 multi-locus sequence typing (MLST) was proposed as a nucleotide sequence-based approach that could be applied to many bacterial pathogens. It combined developments in high-throughput sequencing and bioinformatics with established population genetics techniques to provide a portable, reproducible, and scalable typing system that reflected the population and evolutionary biology of bacterial pathogens. MLST schemes have been developed for a variety of procaryotic and eucaryotic pathogens and the data generated have contributed to both epidemiological surveillance and fundamental studies of pathogen biology.

Bacteria↗
PubMed2001

Induction of cross-protection in mice against dolphin Erysipelothrix rhusiopathiae isolates with a swine commercial vaccine.

Erysipelothrix rhusiopathiae is well known to cause disease in dolphins. This disease occurs either in an peracute way, leading to mortality even before clinical signs are observed or in a sub-acute way, characterized by rhomboidal skin lesions, that can be treated with penicillin or its derivatives. Commercial swine vaccines, containing inactivated serotype 2 strains, are currently used for vaccination but it is not known whether these vaccines induce protection against E. rhusiopathiae isolates from dolphins. In the present study, it was demonstrated in a mouse model that vaccination with a commercial swine vaccine (Eurovac Ery, Eurovet, Belgium) containing inactivated serotype 2 E. rhusiopathiae strains induced protection against challenge with three E. rhusiopathiae isolates from dolphins. The duration of the protection varied, depending on the challenging isolate, between 8 and >23 weeks. There was however no positive correlation between the amount of antibodies at the moment of challenge and the observed protection. In conclusion, vaccination trials in mice indicate that commercial serotype 2 swine Erysipelothrix vaccines induce protection against erysipelas caused by dolphin pathogenic isolates.

Animals↗
PubMed1989

Isoenzyme analysis of typhoid-Shigella and Escherichia-Shigella hybrid vaccines and their parental strains.

Isoenzyme analysis can be used to measure phenotypic changes and to characterize bacterial strains. The use of isoenzyme analysis to characterize bacterial hybrid vaccine strains that were prepared for human vaccination is described in this report. The hybrid vaccine strains were two lots of Salmonella typhi-Shigella sonnei vaccine, two lots of Escherichia coli-Shigella flexneri vaccine, and their parental strains. The two lots of S. typhi-S. sonnei hybrid vaccine had only 5 of 11 reactive isoenzymes in common. The lot of S. typhi-S. sonnei hybrid vaccine that protected human volunteers in a clinical trial also had a greater degree of relatedness to the parental strain, S. typhi Ty21a, than the nonprotective lot. The two lots of E. coli-S. flexneri vaccine were more similar in terms of their isoenzyme profiles. There were colonial isolates from both lots that had identical isoenzyme profiles. The results also indicate a greater degree of homogenicity between Shigella spp. and E. coli than between either of these species and Salmonella spp. The data also show more isoenzyme activity associated with the nonpathogenic bacteria than with pathogenic isolates. Isoenzyme analysis is a rapid and specific assay that can be used to evaluate bacterial vaccine organisms and to establish isoenzyme profiles associated with vaccine immunogenicity and efficacy.

Bacterial Vaccines↗
PubMed1997

[Bacteremia: a Spanish multicenter study with 5000 cases. The Hospital Infection Study Group (GEIH)].

INTRODUCTION: Bacteremia is one of the most common nosocomial infections and is still a severe condition that frequently represents a life-threatening problem for the patient. MATERIAL AND METHODS: SEPSIS DATA is a software programme developed by the SEIMC (Spanish Society of Infectious Diseases and Clinical Microbiology) nosocomial infection study group, and it has been designed to collect under common criteria bacteremia cases from Spanish hospitals. In this study, we analyse the results from the first 5,000 cases prospectively collected from 34 hospitals with the following distribution by number of beds: 8 hospitals with less than 200, 15 between 200 and 499.6 between 500 and 999 and 5 with more than 1,000 beds. RESULTS: Male patients (60%), older than 61 years (52%) are the predominant group. Bacteremia acquisition was extra-hospital in 58% of the cases. Most frequent underlying disease was neoplasm (22%) and 9% of the patients had HIV infection. Most frequent bacteremia sources were urinary tract (19.6%), primary (16%) and respiratory tract (15%). Most commonly isolated micro-organisms were E. coli (23%). S. aureus (13%), coagulase-negative Staphylococci (12%) and S. pneumoniae (8%). Microorganisms average time to grow in laboratory was 1.95 days. Origin focus of bacteremia was reported in 30% of the cases. Antibiotic therapy used was active against pathogen isolate in 96% of the cases. Adequate treatment was started empirically from the first day in 76% of the cases. Third generation cephalosporines were the antibiotic group most used (28%). Among the observed complications, 7.68% of the episodes occurred with shock and 2.68% with septic metastasis. Crude mortality until the end of episode was 16.64%.

Adult↗
PubMedDate not supplied

Nosocomial significant bacteriuria: prevalence and pattern of bacterial pathogens among children hospitalised for non-infective urinary tract disorders.

This study was undertaken to determine the prevalence of nosocomial significant bacteriuria (NSB) and pattern of bacterial pathogens among children hospitalised for non-infective urinary rtract disorders (NUTDs) namely, acute glomerulonephritis, nephrotic syndrome, renal failure and congenital urinary tract anormalies in our nephrology unit. Serial midstream or suprapubic puncture urine specimens were collected into sterile plastic universal bottles from the patients for microscopy, culture and sensitivity, using the standard laboratory methods. Seventeen of the 96 patients admitted for NUTDs were excluded from the study based on the set exclusion criteria; only 19 out of the 79 patients studied were found to have NSB giving a prevalence rate of 24.05%. The isolated pathogens included Klebsiella spp. (47.37%). Staphylococcus aureus (31.58%). Escherichia coli (10.53%), Pseudomonas spp. (5.26%) and Citobacter spp. (5.26%). While 78.95% and 69.23% of the isolates were sensitive to gentamicin and cefuroxime respectively, 57.9% were sensitive to ceftazidime and nitrofurantoin. Less than 50% of the isolates were sensitive to each of the other antibiotics tested. Five of the patients died giving a case fatality rate of 26.3%. In this study, NSB is evidently a very common health problem and a significant risk factor for mortality in patients with NUTDs. Weekly urine culture is recommended in any hospitalised child with NUTD in order to diagnose and manage NSB early before clinical deterioration sets in.

Adolescent↗
PubMed2003

Prevalence of nosocomial infections in Italy: result from the Lombardy survey in 2000.

A one-day survey was carried out in 88 out of 113 public hospitals in Lombardy to obtain prevalence rates of hospital-acquired infections (HAIs) by hospital departments and to identify the pathogens more frequently involved. In total 18667 patients were surveyed, representing 72% of the average daily total of occupied beds in public hospitals in Lombardy. The overall prevalence of HAI was 4.9%. The highest prevalence was observed in intensive care units and in spinal units. The prevalence of bloodstream infections was 0.6%; pneumonia 1.1%; urinary tract infections 1.6% and gastrointestinal infections 0.4%. In surgical patients the prevalence of surgical site infections was 2.7%. The most frequently isolated pathogen from all sites of infections was Escherichia coli (16.8%), followed by Staphylococcus aureus (15.0%), Pseudomonas aeruginosa (13.2%) and Candida spp. (8.7%). Methicillin-resistant S. aureus accounted for 23% of all isolated S. aureus. The results provide baseline data for rational priorities in allocation of resources, for further studies and for infection control activities.

Candidiasis↗