Incidence of hospital-acquired and community-acquired bloodstream infections in the University of Strasbourg Hospital, France, between 2005 and 2007

Objective. - To follow the evolution of incidence of the main feature of bloodstream infections identified in a french hospital between 2005 and 2007. Methods. - We included all the patients hospitalised during three times three-month periods, according to the protocol given by the coordination center against nosocomial infections. For every positive blood culture, we collected clinical and microbiological datas. Results. - Hospital-acquired bacteremias are the most frequent with an incidence rate between 0.996 to 1.31 parts per thousand days of hospitalisation. The population is mainly over 50 years old. The main sources of infection are central catheter, digestive and urinary tracts. Organisms causing the majority of nosocomial bloodstream infections are coagulase-negative staphylococci, Staphylococcus aureus and Escherichia coli. The mortality rate during the first week varies from 16% in 2005 to 8% in 2007. Community-acquired bloodstream infections represent 28% of all episodes, and affect people who are over 70 years old. The main sources of infection are urinary, digestive and pulmonary. Escherichia coli, Staphylococcus aureus and Streptococcus pneumoniae are most frequently isolated. The mortality rate during the first week varies from 3.7 to 9.8% according to the year of study. Conclusion. - This annual investigation enables us to mesure the infection risk level in our hospital, to identify the main sources implied and to create targeted actions to prevent nosocomial bloodstream infections. (C) 2009 Elsevier Masson SAS. All rights reserved.