Nosocomial blood stream infection in Auckland Healthcare hospitals

Aim. To report the epidemiology of nosocomial bloodstream infections in Auc kland Healthcare Hospitals. Methods. From January 1995 to December 1997 every positive blood culture re sult was followed up by an infection control nurse who recorded relevant cl inical, laboratory and treatment information on a data collection sheet. Th e clinical significance of each isolate was determined and the most likely source recorded. Results. During the three year study period, there were 1046 nosocomial blo od stream infections yielding 1147 isolates. The most common isolates/group s were: coagulase negative staphylococci 19%, S. aureus 18%, E. coli 12%, s treptococci 10%, other Enterobacteriaceae 10%, Enterobacter spp, 7%, Pseudo monas spp. 5%, anaerobes 2%, and yeasts 4%. The most common sources were: i ntravascular lines 40%, urinary tract 8%, skin/soft tissue 8%, gastrointest inal 7%, and unknown 25%. The overall results were strongly influenced by t he neonatal intensive care unit at National Women's Hospital where 58% of b lood stream infections had intravascular-lines as the source and 53% of the isolates were coagulase negative staphylococci. The overall blood stream i nfection rate was approximately 6/1000 admissions. Rates per 1000 inpatient days for haematology, intensive care, oncology, neonatal and all other pat ients were 13, 11, 3, 3 and 1 respectively. Conclusions. Surveillance data that are clinically relevant are useful in i dentifying areas where infection prevention strategies can be implemented. Because of the importance of lines as a source of nosocomial brood stream i nfections all aspects of line care are being reviewed with the aim of reduc ing these devices as a source of blood stream infection.