BMJ 2000;320:213-216 ( 22 January )

Papers

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

Editorial by Amyes

Mark H Reacher, consultant epidemiologist, a Anita Shah, information officer, a David M Livermore, director, b Martin C J Wale, head, d Catriona Graham, statistician, e Alan P Johnson, clinical scientist, b Hilary Heine, head of information unit, a Marjorie A Monnickendam, editor, f Keith F Barker, senior medical adviser, g Dorothy James, information officer, b Robert C George, director. c

a Public Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ, b Antibiotic Resistance Monitoring and Reference Laboratory, PHLS Central Public Health Laboratory, London NW9 5HT, c Respiratory and Systemic Infection Laboratory, PHLS Central Public Health Laboratory, d PHLS Antimicrobial Susceptibility Surveillance Unit, Queen's Medical Centre, Nottingham NG7 2UH, e PHLS Statistics Unit, London NW9 5EQ, f PHLS Headquarters, London NW9 5DF, g International Medical Department, SmithKline Beecham, SB House, Brentford, Middlesex TW8 9BD

Correspondence to: M Reacher mreacher{at}phls.nhs.uk

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.


© BMJ 2000
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Articles

Reporting of blood cultures shows worrying increase in antibiotic resistance in England and Wales
BMJ 2000 320: 0. [Full Text]

The rise in bacterial resistance
S G B Amyes
BMJ 2000 320: 199-200. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Reynolds, R. (2009). Antimicrobial resistance in the UK and Ireland. J Antimicrob Chemother 64: i19-i23 [Abstract] [Full text]  
  • Reynolds, R., Hope, R., Williams, L., on behalf of the BSAC Working Parties on Resistanc, (2008). Survey, laboratory and statistical methods for the BSAC Resistance Surveillance Programmes. J Antimicrob Chemother 62: ii15-ii28 [Abstract] [Full text]  
  • Livermore, D. M., Hope, R., Brick, G., Lillie, M., Reynolds, R., on behalf of the BSAC Working Parties on Resistanc, (2008). Non-susceptibility trends among Enterobacteriaceae from bacteraemias in the UK and Ireland, 2001-06. J Antimicrob Chemother 62: ii41-ii54 [Abstract] [Full text]  
  • Livermore, D. M., Hope, R., Brick, G., Lillie, M., Reynolds, R., on behalf of the BSAC Working Parties on Resistanc, (2008). Non-susceptibility trends among Pseudomonas aeruginosa and other non-fermentative Gram-negative bacteria from bacteraemias in the UK and Ireland, 2001-06. J Antimicrob Chemother 62: ii55-ii63 [Abstract] [Full text]  
  • Hope, R., Livermore, D. M., Brick, G., Lillie, M., Reynolds, R., on behalf of the BSAC Working Parties on Resistanc, (2008). Non-susceptibility trends among staphylococci from bacteraemias in the UK and Ireland, 2001-06. J Antimicrob Chemother 62: ii65-ii74 [Abstract] [Full text]  
  • Brown, D. F. J., Hope, R., Livermore, D. M., Brick, G., Broughton, K., George, R. C., Reynolds, R., on behalf of the BSAC Working Parties on Resistanc, (2008). Non-susceptibility trends among enterococci and non-pneumococcal streptococci from bacteraemias in the UK and Ireland, 2001-06. J Antimicrob Chemother 62: ii75-ii85 [Abstract] [Full text]  
  • Smith, K., Hunter, I. S. (2008). Efficacy of common hospital biocides with biofilms of multi-drug resistant clinical isolates. J Med Microbiol 57: 966-973 [Abstract] [Full text]  
  • Wood, F., Simpson, S., Butler, C. C (2007). Socially responsible antibiotic choices in primary care: a qualitative study of GPs' decisions to prescribe broad-spectrum and fluroquinolone antibiotics. Fam Pract 24: 427-434 [Abstract] [Full text]  
  • BALLAL, M. S. G., EMMS, N., O'DONOGHUE, M., REDFERN, T. R. (2007). Rhys-Davies Exsanguinator: A Haven for Bacteria. J Hand Surg Eur Vol 32: 452-456 [Abstract] [Full text]  
  • Livermore, D. (2007). The zeitgeist of resistance. J Antimicrob Chemother 60: i59-i61 [Abstract] [Full text]  
  • Uslan, D. Z., Crane, S. J., Steckelberg, J. M., Cockerill, F. R. III, St. Sauver, J. L., Wilson, W. R., Baddour, L. M. (2007). Age- and Sex-Associated Trends in Bloodstream Infection: A Population-Based Study in Olmsted County, Minnesota. Arch Intern Med 167: 834-839 [Abstract] [Full text]  
  • Cleven, B. E. E., Palka-Santini, M., Gielen, J., Meembor, S., Kronke, M., Krut, O. (2006). Identification and characterization of bacterial pathogens causing bloodstream infections by DNA microarray.. J. Clin. Microbiol. 44: 2389-2397 [Abstract] [Full text]  
  • Albrecht, S. J., Fishman, N. O., Kitchen, J., Nachamkin, I., Bilker, W. B., Hoegg, C., Samel, C., Barbagallo, S., Arentzen, J., Lautenbach, E. (2006). Reemergence of Gram-negative Health Care-Associated Bloodstream Infections.. Arch Intern Med 166: 1289-1294 [Abstract] [Full text]  
  • Bootsma, M. C. J., Diekmann, O., Bonten, M. J. M. (2006). Controlling methicillin-resistant Staphylococcus aureus: Quantifying the effects of interventions and rapid diagnostic testing. Proc. Natl. Acad. Sci. USA 103: 5620-5625 [Abstract] [Full text]  
  • Short, B. R. D., Vargas, M. A., Thomas, J. C., O'Hanlon, S., Enright, M. C. (2006). In vitro activity of a novel compound, the metal ion chelating agent AQ+, against clinical isolates of Staphylococcus aureus. J Antimicrob Chemother 57: 104-109 [Abstract] [Full text]  
  • Johnson, A. P., Potz, N., Waight, P., Gungabissoon, U., Livermore, D. M., Pebody, R., Miller, E., George, R. C. (2005). Susceptibility of pneumococci causing meningitis in England and Wales to first-line antimicrobial agents, 2001-2004. J Antimicrob Chemother 56: 1181-1182 [Full text]  
  • Livermore, D. M., Hawkey, P. M. (2005). CTX-M: changing the face of ESBLs in the UK. J Antimicrob Chemother 56: 451-454 [Abstract] [Full text]  
  • Johnson, A. P., Pearson, A., Duckworth, G. (2005). Surveillance and epidemiology of MRSA bacteraemia in the UK. J Antimicrob Chemother 56: 455-462 [Abstract] [Full text]  
  • Stampone, L., Del Grosso, M., Boccia, D., Pantosti, A. (2005). Clonal Spread of a Vancomycin-Resistant Enterococcus faecium Strain among Bloodstream-Infecting Isolates in Italy. J. Clin. Microbiol. 43: 1575-1580 [Abstract] [Full text]  
  • Lee, S.-O., Cho, Y. K., Kim, S.-Y., Lee, E. S., Park, S. Y., Seo, Y.-H. (2004). Comparison of Trends of Resistance Rates over 3 Years Calculated from Results for All Isolates and for the First Isolate of a Given Species from a Patient. J. Clin. Microbiol. 42: 4776-4779 [Abstract] [Full text]  
  • Cooper, B. S., Medley, G. F., Stone, S. P., Kibbler, C. C., Cookson, B. D., Roberts, J. A., Duckworth, G., Lai, R., Ebrahim, S. (2004). Methicillin-resistant Staphylococcus aureus in hospitals and the community: Stealth dynamics and control catastrophes. Proc. Natl. Acad. Sci. USA 101: 10223-10228 [Abstract] [Full text]  
  • Reynolds, R., Potz, N., Colman, M., Williams, A., Livermore, D., MacGowan, A., on behalf of the BSAC Extended Working Party on Ba, (2004). Antimicrobial susceptibility of the pathogens of bacteraemia in the UK and Ireland 2001-2002: the BSAC Bacteraemia Resistance Surveillance Programme. J Antimicrob Chemother 53: 1018-1032 [Abstract] [Full text]  
  • Wilcox, M., Nathwani, D., Dryden, M. (2004). Linezolid compared with teicoplanin for the treatment of suspected or proven Gram-positive infections. J Antimicrob Chemother 53: 335-344 [Abstract] [Full text]  
  • Turner, J. M, Hakeem, L. M, Lockman, K A., Bhattacharyya, D. N, Campbell, I. W (2004). Diabetic MRSA foot infection -- role of linezolid therapy. British Journal of Diabetes & Vascular Disease 4: 44-46 [Abstract]  
  • Phillips, I., Casewell, M., Cox, T., De Groot, B., Friis, C., Jones, R., Nightingale, C., Preston, R., Waddell, J. (2004). Does the use of antibiotics in food animals pose a risk to human health? A critical review of published data. J Antimicrob Chemother 53: 28-52 [Abstract] [Full text]  
  • Livermore, D. M., Nichols, T., Lamagni, T. L., Potz, N., Reynolds, R., Duckworth, G. (2003). Ciprofloxacin-resistant Escherichia coli from bacteraemias in England; increasingly prevalent and mostly from men. J Antimicrob Chemother 52: 1040-1042 [Abstract] [Full text]  
  • Allen, S H, Brennan-Benson, P, Nelson, M, Asboe, D, Bower, M, Azadian, B, Gazzard, B, Stebbing, J (2003). Pneumonia due to antibiotic resistant Streptococcus pneumoniae and Pseudomonas aeruginosa in the HAART era. Postgrad. Med. J. 79: 691-694 [Abstract] [Full text]  
  • Duckworth, G. (2003). Controlling methicillin resistant Staphylococcus aureus. BMJ 327: 1177-1178 [Full text]  
  • Sandoe, J. A.T., Witherden, I. R., Cove, J. H., Heritage, J., Wilcox, M. H. (2003). Correlation between enterococcal biofilm formation in vitro and medical-device-related infection potential in vivo. J Med Microbiol 52: 547-550 [Abstract] [Full text]  
  • El Bashir, H, Laundy, M, Booy, R (2003). Diagnosis and treatment of bacterial meningitis. Arch. Dis. Child. 88: 615-620 [Abstract] [Full text]  
  • Decousser, J.-W., Pina, P., Picot, F., Delalande, C., Pangon, B., Courvalin, P., Allouch, P., the ColBVH study group, (2003). Frequency of isolation and antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections: a French prospective national survey. J Antimicrob Chemother 51: 1213-1222 [Abstract] [Full text]  
  • Johnson, A. P., Warner, M., Nguyen-Van-Tam, J. S., Livermore, D. M. (2003). Activity of gemifloxacin against invasive and multi-resistant Streptococcus pneumoniae isolates collected in the UK. J Antimicrob Chemother 51: 188-190 [Full text]  
  • Davies, E G, Sharland, M, Nicoll, A (2003). Health protection and a new strategy for combating infection in children. Arch. Dis. Child. 88: 1-3 [Full text]  
  • Crowcroft, N S, Catchpole, M (2002). Mortality from methicillin resistant Staphylococcus aureus in England and Wales: analysis of death certificates. BMJ 325: 1390-1391 [Full text]  
  • Oteo, J., Campos, J., Baquero, F., Spanish members of the European Antimicrobial Resi, (2002). Antibiotic resistance in 1962 invasive isolates of Escherichia coli in 27 Spanish hospitals participating in the European Antimicrobial Resistance Surveillance System (2001). J Antimicrob Chemother 50: 945-952 [Abstract] [Full text]  
  • Aucken, H. M., Ganner, M., Murchan, S., Cookson, B. D., Johnson, A. P. (2002). A new UK strain of epidemic methicillin-resistant Staphylococcus aureus (EMRSA-17) resistant to multiple antibiotics. J Antimicrob Chemother 50: 171-175 [Abstract] [Full text]  
  • Johnson, A. P., Warner, M., Livermore, D. M. (2002). In vitro activity of a novel oxazolidinone, AZD2563, against randomly selected and multiresistant Gram-positive cocci. J Antimicrob Chemother 50: 89-93 [Abstract] [Full text]  
  • Harbarth, S., Cosgrove, S., Carmeli, Y. (2002). Effects of Antibiotics on Nosocomial Epidemiology of Vancomycin-Resistant Enterococci. Antimicrob. Agents Chemother. 46: 1619-1628 [Full text]  
  • van de Beek, D., de Gans, J., Spanjaard, L., Vermeulen, M., Dankert, J. (2002). Antibiotic guidelines and antibiotic use in adult bacterial meningitis in The Netherlands. J Antimicrob Chemother 49: 661-666 [Abstract] [Full text]  
  • Johnson, A. P., Warner, M., Carter, M., Livermore, D. M. (2002). In Vitro Activity of Cephalosporin RWJ-54428 (MC-02479) against Multidrug-Resistant Gram-Positive Cocci. Antimicrob. Agents Chemother. 46: 321-326 [Abstract] [Full text]  
  • Shannon, K. P., French, G. L. (2002). Antibiotic resistance: effect of different criteria for classifying isolates as duplicates on apparent resistance frequencies. J Antimicrob Chemother 49: 201-204 [Abstract] [Full text]  
  • Johnson, A. P., Aucken, H. M., Cavendish, S., Ganner, M., Wale, M. C. J., Warner, M., Livermore, D. M., Cookson, B. D., UK EARSS participants, t. (2001). Dominance of EMRSA-15 and -16 among MRSA causing nosocomial bacteraemia in the UK: analysis of isolates from the European Antimicrobial Resistance Surveillance System (EARSS). J Antimicrob Chemother 48: 143-144 [Full text]  
  • Henwood, C. J., Warner, M., Waight, P., Johnson, A. P., George, R. C., Livermore, D. M. (2001). Accuracy of routine susceptibility testing of Streptococcus pneumoniae in England and Wales. J Antimicrob Chemother 47: 897-900 [Full text]  
  • Johnson, A. P., Warner, M., George, R. C., Livermore, D. M. (2001). Activity of moxifloxacin against clinical isolates of Streptococcus pneumoniae from England and Wales. J Antimicrob Chemother 47: 411-415 [Abstract] [Full text]  
  • Hebeisen, P., Heinze-Krauss, I., Angehrn, P., Hohl, P., Page, M. G. P., Then, R. L. (2001). In Vitro and In Vivo Properties of Ro 63-9141, a Novel Broad-Spectrum Cephalosporin with Activity against Methicillin-Resistant Staphylococci. Antimicrob. Agents Chemother. 45: 825-836 [Abstract] [Full text]  
  • Henwood, C. J., Livermore, D. M., Johnson, A. P., James, D., Warner, M., Gardiner, A., The Linezolid Study Group, (2000). Susceptibility of Gram-positive cocci from 25 UK hospitals to antimicrobial agents including linezolid. J Antimicrob Chemother 46: 931-940 [Abstract] [Full text]  
  • Livermore, D. M., Stephens, P., Weinberg, J., Johnson, A. P., Gifford, T., Northcott, D., James, D., George, R. C., Speller, D. C. E. (2000). Regional variation in ampicillin and trimethoprim resistance in Escherichia coli in England from 1990 to 1997, in relation to antibacterial prescribing. J Antimicrob Chemother 46: 411-422 [Abstract] [Full text]  
  • Møller, K., Skinhøj, P. (2000). Guidelines for managing acute bacterial meningitis. BMJ 320: 1290-1290 [Full text]  
  • Amyes, S G B (2000). The rise in bacterial resistance. BMJ 320: 199-200 [Full text]  

Rapid Responses:

Read all Rapid Responses

The culture of cultures
Tom Oommen
bmj.com, 25 Jan 2000 [Full text]
Endocarditis prophylaxis and antibiotic resistance
C Kerawala
bmj.com, 7 Feb 2000 [Full text]
Multi-resistant bacteria - implications for health planning
J W Myles
bmj.com, 19 Feb 2000 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ