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15 September 2005

Volume 41, Number 6
Clinical Infectious Diseases 2005;41:848–854
This article is in the public domain, and no copyright is claimed.
1058-4838/2005/4106-0015
DOI: 10.1086/432803
HEALTHCARE EPIDEMIOLOGY INVITED ARTICLE

Overview of Nosocomial Infections Caused by Gram‐Negative Bacilli

Robert Gaynes,

Jonathan R. Edwards, and the

National Nosocomial Infections Surveillance System

Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

We analyzed data from the National Nosocomial Infections Surveillance (NNIS) System from 1986–2003 to determine the epidemiology of gram‐negative bacilli in intensive care units (ICUs) for the most frequent types of hospital‐acquired infection: pneumonia, surgical site infection (SSI), urinary tract infection (UTI), and bloodstream infection (BSI). We analyzed >410,000 bacterial isolates associated with hospital‐acquired infections in ICUs during 1986–2003. In 2003, gram‐negative bacilli were associated with 23.8% of BSIs, 65.2% of pneumonia episodes, 33.8% of SSIs, and 71.1% of UTIs. The percentage of BSIs associated with gram‐negative bacilli decreased from 33.2% in 1986 to 23.8% in 2003. The percentage of SSIs associated with gram‐negative bacilli decreased from 56.5% in 1986 to 33.8% in 2003. The percentages pneumonia episodes and UTIs associated with gram‐negative bacilli remained constant during the study period. The proportion of ICU pneumonia episodes associated with Acinetobacter species increased from 4% in 1986 to 7.0% in 2003 ( , by the Cochran‐Armitage χ2 test for trend). Significant increases in resistance rates were uniformly seen for selected antimicrobial‐pathogen combinations. Gram‐negative bacilli are commonly associated with hospital‐acquired infections in ICUs. The proportion of Acinetobacter species associated with ICU pneumonia increased from 4% in 1986 to 7.0% in 2003.

Received 24 March 2005; accepted 24 May 2005; electronically published 16 August 2005.

Reprints or correspondence: Dr. Robert P. Gaynes, 1600 Clifton Rd. NE, Mail Stop A07, Centers for Disease Control and Prevention, Atlanta, GA 30333 ().

Robert A. Weinstein, Section Editor

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  • Presented in part: 44th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, DC, October 30–2 November 2004 (abstract 401).

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