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Ten years of blood cultures surveillance in an intensive care unit of a tertiary hospital in Israel

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Carmel Medical Center is a tertiary hospital with 430 beds. The intensive care unit (ICU) has 7 beds and admits patients from all hospital departments. The objectives of this study were to analyze the etiologies of blood cultures (BC) in ICU and to compare them to those obtained from the departments. The study period included retrospectively ten years from 1988 to 1998, excluding 1990. During this period 4497 positive BC in different patients were reported from the hospital. 3976 BC including 835 from ICU were analyzed. These BC represent 90% of most commonly found Gram positive and negative bacteria. The distribution of Gram negative/Gram positive BC was respectively 61%/39% for the ICU and 53%/47% for the departments. This difference is statistically significant. In decreasing order of incidence the most important bacteria in the ICU were: Klebsiella 23.8%, Pseudomonas 15.6%, MRSA 11.9%, MRSE 10.5%, Acinetobacter 8.7%, Stapylococcus aureus 6.7%, E. coli 5.4%, Enterococcus 4.7% and Enterobacter 4.7%. The most important bacteria from departments were: E. coli 19.9%, Klebsiella 13.2%, Staphylococcus aureus 11.4%, Streptococcus 9.2%, MRSE 8.2%, Pseudomonas 7.1%, Acinetobacter 5.3%, Enterococcus 5.2%, Staphylococcus epidermidis 4.9%, MRSA 4.1%.


In spite of continuous transfer of patients from departments to ICU and from ICU to departments, the etiology of BC is different. E. coli and Staphylococcus aureus are the most predominant Gram negative/positive bacteria from the hospital departments, reflecting community acquisition. Klebsiella and MRSA are the most predominant Gram negative/positive bacteria in the ICU. The etiologies of BC remain stable throughout the years for the majority of bacteria excluding outbreaks of MRSA and Acinetobacter in the ICU.

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Kitzes, R., De Myttenaere-Bursztein, S., Sheskin, A. et al. Ten years of blood cultures surveillance in an intensive care unit of a tertiary hospital in Israel. Crit Care 4 (Suppl 1), P79 (2000).

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