Bacteraemia and antibiotic resistance of its pathogens reported in Englandand Wales between 1990 and 1998: trend analysis

Objectives Determination of causes, trends, and antibiotic resistance in re ports of bacterial pathogens isolated from blood in England and Wales from 1990 to 1998. Design Description of bacterial isolates from blood, judged to be clinicall y significant by microbiology staff, reported to the Communicable Disease S urveillance Centre. Setting Microbiology laboratories in England and Wales. Subjects Patients yielding clinically significant isolates from blood. Main outcome measures Frequency and Poisson regression analyses for trend o f reported causes of bacteraemia and proportions of antibiotic resistant is olates. Results There was an upward trend in total numbers of reports of bacteraemi a. The five most cited organisms accounted for over 60% of reports each yea r. There was a substantial increase in the proportion of reports of Staphyl ococcus aureus resistant to methicillin, Streptococcus pneumoniae resistanc e to penicillin and erythromycin, and Enterococcus faecalis and Enterococcu s faecium resistance to vancomycin. No increase was seen in resistance of E scherichia coli to gentamicin. Conclusions Reports from laboratories provide Valuable information on trend s and antibiotic resistance in bacteraemia and show a worrying increase in resistance to important antibiotics.