Intended for healthcare professionals


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

BMJ 2000; 320 doi: (Published 22 January 2000) Cite this as: BMJ 2000;320:213
  1. Mark H Reacher, consultant epidemiologist (mreacher{at},
  2. Anita Shah, information officera,
  3. David M Livermore, directorb,
  4. Martin C J Wale, headd,
  5. Catriona Graham, statisticiane,
  6. Alan P Johnson, clinical scientistb,
  7. Hilary Heine, head of information unita,
  8. Marjorie A Monnickendam, editorf,
  9. Keith F Barker, senior medical adviserg,
  10. Dorothy James, information officerb,
  11. Robert C George, directorc
  1. a Public Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ
  2. b Antibiotic Resistance Monitoring and Reference Laboratory, PHLS Central Public Health Laboratory, London NW9 5HT
  3. c Respiratory and Systemic Infection Laboratory, PHLS Central Public Health Laboratory
  4. d PHLS Antimicrobial Susceptibility Surveillance Unit, Queen's Medical Centre, Nottingham NG7 2UH
  5. e PHLS Statistics Unit, London NW9 5EQ
  6. f PHLS Headquarters, London NW9 5DF
  7. g International Medical Department, SmithKline Beecham, SB House, Brentford, Middlesex TW8 9BD
  1. Correspondence to: M Reacher
  • Accepted 5 November 1999


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.


  • Funding Public Health Laboratory Service.

  • Competing interests None declared.

  • Accepted 5 November 1999
View Full Text