Current Issue: Volume 16 Number 51	Published on: 21 December 2006	Current Issue in PDF PDF format (283 Kb)

Bacteraemia

Last updated: 21 December, Volume 16, No. 51 ( KB) Next update: 19 January 2007

Bacteraemia Archives: | 2006 | 2005 | 2004 | 2003 | 2002 | 2001

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• Results of the voluntary reporting scheme for bacteraemia due to Enterococcus spp, England, Wales, and Northern Ireland: 2005
• Uncommon pathogens involved in bacteraemia, England, Wales, and Northern Ireland: 2001 to 2005
  

Results of the voluntary reporting scheme for bacteraemia due to Enterococcus spp, England, Wales, and Northern Ireland: 2005

This report covers voluntary reports of bacteraemia due to Enterococcus spp (including Group D streptococci) made to the Health Protection Agency in 2005 from laboratories in England, Wales, and Northern Ireland. Age-specific rates of enterococcal bacteraemia were calculated using Office of National Statistics 2005 mid-year resident population estimates as denominators. Data were extracted on 25 October 2006, by which time ascertainment for 2005 should be near complete. Data were analysed and displayed according to current regional boundaries, and are provisional..

Where the percentage resistance to a specific antibiotic is given, the denominator excludes those reports without any susceptibility information for that antibiotic.

• In 2005 there were 7066 laboratory reports (table 1) of enterococcal bacteraemia, compared to 6533 reports in 2004. This represents an 8% increase, a level of increase which has not been observed for bacteraemias caused by other species in the same period.
  
• In 2005, E. faecalis accounted for 63% and E. faecium for 28% of reports where enterococci were identified to species level; these results are similar to those noted in 2004. However, examination of reported resistance patterns, particularly ampicillin/amoxycillin and dalfopristin/quinupristin, has highlighted continuing possible misidentification of enterococci.
  
• More than half of the E. faecalis and E. faecium reports were in those aged 65 years and over.
  
• Susceptibility reporting indicated that 3% of E. faecalis and 25% of E. faecium bacteria were resistant to vancomycin. The former will be an overestimate if some E. faecium, in which vancomycin resistance is more common, are being misidentified as E. faecalis.
  
• Resistance or intermediate resistance to linezolid was reported in 12 (1%) of 1123 enterococci reports that contained susceptibility information for this antibiotic. Linezolid resistance remains uncommon and it is important to confirm this resistance: any such isolates should be forwarded to the Health Protection Agency’s Antibiotic Resistance Monitoring and Reference Laboratory (ARMRL). Investigation of unusual resistance reports is a function of this reference service.
  
• In addition to voluntary surveillance of enterococcal bacteraemia, mandatory surveillance of bacteraemia specifically due to glycopeptide-resistant enterococci (GRE) commenced in October 2003. The most recent publication of these results can be found at <http://www.hpa.org.uk/infections/topics_az/hai/mandatory_report_2006.htm>. Information on the mandatory GRE bacteraemia surveillance scheme at <http://www.hpa.org.uk/infections/topics_az/enterococci/mandatory_surveillance.htm>.

Table 1 Laboratory reports of bacteraemia due to Enterococcus spp, England, Wales, and Northern Ireland: 2003 and 2005

*As a percentage of all reports where enterococci were identified to species level.

Further data tables and graphs about Enterococcus spp bacteraemias, England, Wales, and Northern Ireland: 2005 can be viewed at < http://www.hpa.org.uk/infections/topics_az/enterococci/voluntary_surveillance_results.htm >

Uncommon pathogens involved in bacteraemia, England, Wales, and Northern Ireland: 2001 to 2005

This report concerns bacteria identified from blood samples and reported voluntarily by laboratories in England, Wales, and Northern Ireland, from 2001 to 2005. The reports were made to the Health Protection Agency’s Centre for Infections. Data were extracted on 23 November 2006, by which time ascertainment for 2005 should be near complete. Data are provisional.

This report covers uncommon pathogens involved in bacteraemias. Uncommon pathogens are defined as organisms from genera with small numbers of reports in 2005.

Some of these voluntary reports provide further details on clinical history, such as history of recent surgery, recent travel history, and risk factors (eg, use of an intravascular line). This limited information does not include details of the clinical significance of the infection, whether or not it was acquired in the community or in hospital, or whether or not it was identified and treated as the cause of the clinical condition.

A list of uncommon pathogens reported between 2001 and 2005 can be <http://www.hpa.org.uk/infections/topics_az/bacteraemia/Uncommon/Uncommon_2001_2005.htm>

Specific queries about this report can be sent to hcai.amrdivision@hpa.org.uk