Background: To try established antimicrobial susceptibility patterns and frequency of both nosocomial and community-acquired bloodstream infections and and to try identified the prognostic factors that can be modified.
Material and methods: A prospective study of 310 bloodstream infections with clinical significance detected in a non teaching hospital over period from October 2000-2001. A blood culture were identified by Bact-Alert system and the confirmation was performed by MicroScan system; an antimicrobial susceptibility test was performed by reference microdilution methods as described by NCCLS. We studied sentinel antimicrobial/organism combinations with potential clinical importance. Data were computerized using SPSS. Qualitative variables were compared using the X2 test or the Fisher exact test, and quantitative variables with t Student or ANOVA.
Results: Gram positive and Candida were frequently recovered in nosocomial bloodstreams. The proportion of oxacillin-resistant S. aureus isolates was 24% and the penicillin resistant pneumococci was 14%. Vancomycin was universal active against gram positive. Gram negatives were often recovered in community bloodstream. The proportion of EBSL E. coli isolates was < 2% and the proportion of multiresistance Pseudomonas aeruginosa was higher among UCI isolates. An independent risk factors for death identified after multivariate analysis was the inappropriate antimicrobial therapy OR 2.6.
Conclusions: Ongoing surveillance of microbial pathogens and their resistance profiles is essential on local scale and permit the selection of appropriate antibiotic therapy which would be reduce the mortality.