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Epidemiology of community‐acquired and nosocomial bloodstream infections in tropical Australia: a 12‐month prospective study
Author(s) -
Douglas Mark W.,
Lum Gary,
Roy Jhumur,
Fisher Dale A.,
Anstey Nicholas M.,
Currie Bart J.
Publication year - 2004
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2004.01269.x
Subject(s) - pneumonia , burkholderia pseudomallei , epidemiology , staphylococcus aureus , incidence (geometry) , blood culture , medicine , vancomycin , bacteremia , prospective cohort study , antibiotics , community acquired pneumonia , mortality rate , microbiology and biotechnology , biology , bacteria , genetics , physics , optics
Objectives To define the relative incidence of organisms causing blood stream infections in a tropical setting with a very low prevalence of human immunodeficiency virus infection (<1%). Methods A 12‐month prospective study of blood stream infections in 2000 at Royal Darwin Hospital in the tropical north of Australia. Results Significant isolates were grown from 257 sets of blood cultures. Staphylococcus aureus was the most common isolate overall (28%); 26% of these were methicillin‐resistant (MRSA). Escherichia coli was the most common cause of community‐acquired bacteraemia. Burkholderia pseudomallei caused 32% of community acquired, bacteraemic pneumonia; 6% of bacteraemias overall. Vancomycin‐resistant enterococci were not isolated. Crude mortality rates (13% overall; 9% attributable mortality) were lower than in most comparable studies. Conclusions The major difference between these findings and surveys performed elsewhere is the presence of B. pseudomallei as a significant cause of bacteraemic community‐acquired pneumonia. Our results demonstrate the effects of local environmental and patient characteristics on the range of organisms causing blood stream infections, and emphasize the important role of local microbiology laboratories in guiding empiric antibiotic therapy.