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. 2000 Jan 22;320(7229):213-6.
doi: 10.1136/bmj.320.7229.213.

Bacteraemia and antibiotic resistance of its pathogens reported in England and Wales between 1990 and 1998: trend analysis

M H Reacher  1 , A Shah, D M Livermore, M C Wale, C Graham, A P Johnson, H Heine, M A Monnickendam, K F Barker, D James, R C George
Affiliations

Bacteraemia and antibiotic resistance of its pathogens reported in England and Wales between 1990 and 1998: trend analysis

M H Reacher et al. BMJ. .

Abstract

Objectives: Determination of causes, trends, and antibiotic resistance in reports of bacterial pathogens isolated from blood in England and Wales from 1990 to 1998.

Design: Description of bacterial isolates from blood, judged to be clinically significant by microbiology staff, reported to the Communicable Disease Surveillance Centre.

Setting: Microbiology laboratories in England and Wales.

Subjects: Patients yielding clinically significant isolates from blood.

Main outcome measures: Frequency and Poisson regression analyses for trend of reported causes of bacteraemia and proportions of antibiotic resistant isolates.

Results: There was an upward trend in total numbers of reports of bacteraemia. The five most cited organisms accounted for over 60% of reports each year. There was a substantial increase in the proportion of reports of Staphylococcus aureus resistant to methicillin, Streptococcus pneumoniae resistance to penicillin and erythromycin, and Enterococcus faecalis and Enterococcus faecium resistance to vancomycin. No increase was seen in resistance of Escherichia coli to gentamicin.

Conclusions: Reports from laboratories provide valuable information on trends and antibiotic resistance in bacteraemia and show a worrying increase in resistance to important antibiotics.

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Figures

Figure 1
Figure 1
Incidence of commonly reported causes of bacteraemia in England and Wales, 1990 to 1998
Figure 2
Figure 2
Common causes of bacteraemia by age group as proportion of total reports for England and Wales, 1998 (age group <1 month equals ⩽28 days; 1-11 months equals 29-365 days)
Figure 3
Figure 3
Antibiotic resistance ((number resistant + number intermediate)/(number resistant + number intermediate + number sensitive) x 100) in bacteraemia isolates (lines) and numbers of reports with antibiotic susceptibility data (bars) in England and Wales, 1990 to 1998
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