Epidemiology of nosocomial bloodstream infections in Belgium, 1992-1996

The main results of the bloodstream infection (BSI) component of the Belgia n National Programme for the Surveillance of Hospital Infections (NSIH proj ect) are reported. From October 1992 to September 1996, 117 hospitals (59.1 % of Belgian acute-care institutions) reported 13 678 nosocomial BSIs. The incidence was 7.05 BSI episodes per 10 000 patient-days. The incidence of B SI increased with hospital size and over time. Bloodstream infections were secondary to an infectious body site in 40.3% of the episodes, catheter-rel ated in 23.5%, and of unknown origin in 36.2%. The associated in-hospital m ortality was 31.4% and was highest in BSIs secondary to a respiratory tract infection (49.3%). In intensive care units, the incidence of BSI was 38.5 per 10 000 patient-days. Coagulase-negative staphylococci were the most pre valent microorganisms (22%), followed by Staphylococcus aureus (14.1%) and Escherichia coli (13.5%). In catheter-related BSIs, these proportions were 41.9%, 18.8%, and 2.3%, respectively. The proportion of polymicrobial episo des was 9.9%. Methicillin resistance in Staphylococcus aureus was 22.3%. Wi th its high participation rate, the NSIH project has characterized the epid emiology of nosocomial BSIs in Belgium during the period studied.