JAC Advance Access published online on March 10, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh159
© 2004 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of Infectious
Disease Epidemiology, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki
* Corresponding author. E-mail: outi.lyytikainen{at}ktl.fi.
Received 9 December 2003
; 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 ( 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
Nosocomial bloodstream infections due to viridans
streptococci in haematological and non-haematological patients:
species distribution and antimicrobial resistance
2 Department of Microbiology,
National Public Health Institute, Mannerheimintie 166, 00300 Helsinki; Jorvi Hospital, Espoo;
3 Jorvi Hospital, Espoo; Helsinki University Central Hospital,
Helsinki;
4 Helsinki University Central Hospital,
Helsinki;
5 Tampere University
Hospital, Tampere;
6 Päijät-Häme
Central Hospital, Lahti, Finland
7 Jorvi Hospital, Espoo;
8 Department of Microbiology,
National Public Health Institute, Mannerheimintie 166, 00300 Helsinki;
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.
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