JAC Advance Access originally published online on March 10, 2004
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Journal of Antimicrobial Chemotherapy (2004) 53, 631-634
© 2004 The British Society for Antimicrobial Chemotherapy
Nosocomial bloodstream infections due to viridans streptococci in haematological and non-haematological patients: species distribution and antimicrobial resistance
Departments of 1 Infectious Disease Epidemiology and 2 Microbiology, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki; 3 Jorvi Hospital, Espoo; 4 Helsinki University Central Hospital, Helsinki; 5 Tampere University Hospital, Tampere; 6 Päijät-Häme Central Hospital, Lahti, Finland
Received 9 December 2003; returned 13 January 2004; revised 2 February 2004; accepted 2 February 2004
Objectives: We studied the species distribution and antimicrobial susceptibility of viridans streptococci (VS) isolates causing nosocomial bloodstream infections (BSIs) in Finnish hospitals.
Patients and methods: Patients with nosocomial BSIs due to VS were identified through a hospital-wide prospective laboratory-based surveillance in two university and two regional hospitals during September 1998–August 2001. Isolates of VS were sent to the reference laboratory for species confirmation and antimicrobial susceptibility testing.
Results: A total of 2038 nosocomial BSIs were identified; 108 (5%) of the BSIs were caused by VS. Of the VS BSIs, 66% were in patients with a haematological malignancy, 14% in patients with a solid tumour and 18% in patients who had undergone surgery preceding the infection. The most common species group identified was Streptococcus mitis (82%). High-level penicillin resistance (
4mg/L) and cefotaxime resistance (4mg/L) were present in 5% and 4% of isolates, respectively; both were detected only in haematological patients. However, in non-haematological patients, resistance to erythromycin (17%), and reduced susceptibility to levofloxacin (14%) and penicillin (19%) were common.
Conclusions: The resistance problems in VS are not limited to haematological patients. These findings may have significant clinical implications in the choice of both empirical antibiotic and antimicrobial prophylaxis regimens.
Keywords: epidemiology, surveillance, antibiotic resistance
* Corresponding author. Tel: +358-9-47448783; Fax: +358-9-47448468; E-mail: outi.lyytikainen{at}ktl.fi
Members of the Hospital Infection Surveillance Team are listed in the Acknowledgements.
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