Epidemiology of septicaemia pathogens

Abstract

Because of high mortality of septicaemia correct initial antimicrobial treatment is essential. Multicentre studies sponsored by Paul-Ehrlich-Society provide the necessary epidemiological data. Two institutes from Austria and 20 from Germany participated in this third one year study on septicaemia pathogens conducted between September 2000 to August 2001. Data on gender, age, hospital, department, ward, pathogen, susceptibility pattern, underlying disease and port of entry was collected on 10,052 pathogens from 9,555 patients and compared with the two studies of 1991/92 and 1983/85. Spectrum of pathogen has remained constant: E. coli (22.6 %) and S. aureus (21.6 %) were most frequent. There was a further reduction in Haemophilus (0.3 %) and P. aeruginosa (3.4 %). In comparison to second study the rate of pneumococci fell to 3.5 %. There is an increase in resistance to betalactams: oxacillin resistance in S. aureus 15 %, coagulase negative staphylococci 68 %; resistance to ampicillin, piperacillin, cefazolin in E. coli 77, 43 and 25 % respectively. Ciprofloxacin resistance in Enterobacteriaceae is 5 - 15 %. In endocarditis 42.8 % of pathogens were non-haemolytic streptococci or enterococci, in pulmonary infections 42.5 % were S. aureus or pneumococci, in urosepsis resp. abdominal infection 77.2 % resp. 62 % were enterobacteriaceae. In patients with diabetes, or intravascular devices, or undergoing haemodialysis S. aureus was cultured in 30 - 47 %. Demographical parameters are similar. Increase is resistance against beta-lactams and ciprofloxacin and rate of MRSA is reported.