DESCRIPTIVE STUDY OF NOSOCOMIAL BACTEREMIAS AT JOHNS HOPKINS HOSPITAL, 1968-1974

Abstract

Patient, infection and pathogen characteristics are analyzed for 935 cases of nosocomial bacteremia at The Johns Hopkins Hospital, Baltimore, Maryland, USA, 1968-74. The overall nosocomial bacteremia attack rate was 4.1 cases/1000 hospital patients. Roughly 6% of all hospital deaths were among patients with nosocomial bacteremias. The case-fatality rate for the 7 yr was 37.1%, compared with an overall hospital mortality rate of 2.7 deaths/100 hospital patients. The mortality rate for the entire hospital and the case-fatality rate declined significantly (P < .01) over the 7 yr study period. There was a significant increase (P < .01) in gram-positive nosocomial bacteremias over the 7 yr period. During the period, Bacteroides spp. and Escherichia coli bacteremias increased significantly (P < .01), while Candida spp. and Klebsiella spp. bacteremias had significant decreases (P < .01). The nosocomial bacteremia attack rate was high for infants under 1 yr of age, excluding newborns. The attack rates were low for young adults but increased markedly with age in adults older than 40. The cardiac surgery service had the highest nosocomial bacteremia attack rate of 12.4 cases/1000 patients. Hospital patients with infective diseases, neoplasma, digestive diseases, diseases of early infancy or circulatory diseases had a much greater risk of acquiring nosocomial bacteremias. Of the 935 cases, 9.5% had multiple episides of bacteremia.