National Surveillance of Nosocomial Septicemia (Hospital-wide)

Transcription

1 National Surveillance of Hospital Infections National Surveillance of Nosocomial Septicemia (Hospital-wide) National analysis Data from 01/01/2008 to 31/12/2008

2 1. SUMMARY BY QUARTER Quarter Patient records SEP records MO records N of admissions from to 2008q1 01/01/ /04/ d d q2 01/04/ /07/ d d q3 01/07/ /11/ d d q4 01/10/ /01/ d d Patient-days Length of stay N admissions in intensive care Pt-days IC LOS IC N hemoc. N hc/1000 ptd N SEP>D2 % N SEP>D2 icu % TOTAL 01/01/ /01/ d d Page 2 Summary

3 2. Data quality check Total number of surveillance quarters 199 Whocare 0 NSIHwin 199 a. Denominator data a.1. Standard denominator data Complete records 144 Missing n of hospital admissions 0 Missing n of patient-days 0 Missing n of ICU admissions 53 Missing n of ICU patient-days 52 Missing n of hemocultures 2 a.2. Optional data (quality decree Fl. Comm.)* >=1 optional variable 77 Complete records 48 Missing n pts staying>24h in ICU 7 Missing n pt-days for pts>24h in ICU 7 Missing n cvc-days (pts>24h) in ICU, cath.total 24 Missing n cvc-days (pts>24h) in ICU, pt.total 22 *optional b. Septicemia data Total number of septicemia records 5020 Missing micro-organism 7 Missing service where SEP was diagnosed* 105 Missing outcome (follow-up) status 217 Missing outcome (follow-up) date 217 Unlikely delay admission to infection 6 Infection date after discharge date 13 NSIHwin only: Nosocomial judgment out of range 26 Origin SEP out of range 0 Relationship out of range 242 Origin=other infection & no other infection site 229 *replaced by service of admission if available Page 3 Dqc

4 3. TABLES Table 1a : Standard summary A. Denominator data Number of admissions Mean number of admissions per month 953 Number of patient-days Mean length of hospital stay (days)* 7.8 N of admissions in intensive care Mean number of ICU admissions per month 60 N of patient-days in intensive care Mean length of stay in intensive care (days)* 4.3 Number of hemocultures N hemocultures per 1000 patient-days 40.2 *missings excluded B. Septicemia episodes all > Day 2 Total number of septicemia records N SEP with >=1 recognized pathogen (A) N SEP with skin contaminant(s) only of which 2 positive hemocultures (old definition)(b) positive hc + cvc + AB therapy (KD)(C) positive hc, no cvc or AB therapy (deleted)(d) N of septicemia records in analysis(a+b) Whocare 0 0 NSIHwin Nosocomial character (A+B) Not nosocomial Probably nosocomial Definitely nosocomial Incidence a. Hospital-wide all SEP >D2 Incidence per 1000 admissions Incidence per patient-days N sep/100 hemocultures Positive HC % b. Intensive care (all patients) all SEP >D2 Incidence per 1000 admissions Incidence per patient-days Table 1b : KD summary (NSIHwin data) Page 4 Table1

5 A. Denominator data N quarters Number of admissions Number of patient-days Mean length of hospital stay (days)* 7.8 N patients staying>24h in intensive care N of patient-days for pts staying >24h in intensive care Mean length of stay in intensive care (days)* 5.2 Number of catheter-days, patient total CVC days/1000 patient-days* 525 Number of catheter-days, cath.total CVC days/1000 patient-days* 621 *missings excluded B. Septicemia episodes all > Day 2 Total number of septicemia records N SEP with >=1 recognized pathogen (A) N SEP with only skin contaminant(s) of which 2 positive hemocultures (old definition)(b) positive hc + cvc + AB therapy (KD)(C) positive hc, no cvc or AB therapy (deleted) N of septicemia records in analysis(a+b+c) N of primary septicemia Incidence a. Hospital-wide Primary SEP>D2 per 1000 patient-days, hospital b. Intensive care (patients staying>24h) Prim. SEP>D2 on int.care, per 1000 pt-days Cath-ass. SEP>D2 in intensive care, per 1000 cvc-days (pt.total) Cath-ass. SEP>D2 in intensive care, per 1000 cvc-days (cat.total) Page 5 Table1

6 Table 2a: Origin (source) of septicemia Note: SEP>D2, NSIH definition (A+B) Incidence / ptdays Probable (%) Definite (%) Total (%) Catheter-related 260 (7.5) 371 (10.7) 631 (18.2) 1.45 NSIHwin data 260 (7.5) 371 (10.7) 631 (18.2) Central catheter 221 (6.4) 328 (6.4) 549 (15.8) Peripheral catheter 30 (0.9) 13 (0.9) 43 (1.2) Arterial catheter 9 (0.3) 12 (0.3) 21 (0.6) Secondary origin 752 (21.7) 888 (25.6) 1640 (47.2) 3.7 Urinary tract infection 177 (5.1) 384 (11.1) 561 (16.2) Pneumonia 127 (3.7) 114 (3.3) 241 (3.7) Other respiratory tract inf. 98 (2.8) 60 (1.7) 158 (2.8) Inf. gastro-intestinal system 126 (3.6) 82 (2.4) 208 (3.6) Inf. skin/soft tissue 53 (1.5) 43 (1.2) 96 (1.5) Surgical site infection 40 (1.2) 58 (1.7) 98 (1.2) Cardiovascular system inf. 15 (0.4) 16 (0.5) 31 (0.4) Eye/ear/nose/throat/mouth 15 (0.4) 5 (0.1) 20 (0.4) Bone/joint infection 12 (0.3) 11 (0.3) 23 (0.3) Reproductive tract inf. 5 (0.1) 3 (0.1) 8 (0.1) Central nervous system inf. 1 (0.0) 4 (0.1) 5 (0.0) Systemic infection 9 (0.3) 1 (0.0) 10 (0.3) Other infection/ not specified 19 (0.5) 91 (2.6) 110 (0.5) Invasive procedure 48 (1.4) 29 (0.8) 77 (1.4) Foreign body 18 (0.5) 15 (0.4) 33 (0.5) Unknown origin 1200 (34.6) 2.72 TOTAL septicemia >D (100) 7.79 Total NSIHwin data >D (100) Table 2b: Catheter data (optional) Total sep with catheter data 954 Catheter cath-ass.sep sec.sep unkown total Central catheter Peripheral catheter Arterial catheter Catheter-days by catheter type N Mean duration Median duration Central catheters d 10 d Jugular CVC d 11 d Subclavian CVC d 11 d Femoral catheter d 11 d Implanted (Port-a-cath) d 22.5 d Umbilical catheter d 4.5 d Dialysis catheter d 7 d Other/unspecified d 9 d Peripheral catheters d 5 d Arterial catheters d 6.5 d Page 6 Table2

7 Table 3 : Distribution of septicemia by service all >D2 in hospital >D2 in service* Burn 1 (0.0) 1 (0.0) 1 (0.0) General/abdom surg. 362 (7.4) 320 (9.2) 303 (9.4) Cardiovasc.surg 90 (1.8) 81 (2.3) 77 (2.4) Mixed surgical/medic 152 (3.1) 113 (3.3) 108 (3.3) Neurosurgery 47 (1.0) 43 (1.2) 39 (1.2) Orthopedics 110 (2.3) 96 (2.8) 93 (2.9) Plastic surgery 6 (0.1) 5 (0.1) 5 (0.2) Urology 103 (2.1) 59 (1.7) 51 (1.6) Other surgery 39 (0.8) 26 (0.7) 25 (0.8) Geriatrics 564 (11.6) 410 (11.8) 394 (12.2) Gynecology 21 (0.4) 15 (0.4) 14 (0.4) Intensive care 885 (18.2) 754 (21.7) 651 (20.1) Cardiology 212 (4.3) 168 (4.8) 156 (4.8) Endocrinology 14 (0.3) 8 (0.2) 7 (0.2) Internal Medicine 626 (12.8) 404 (11.6) 384 (11.9) Nephrology 118 (2.4) 64 (1.8) 58 (1.8) Oncology/Hematology 485 (9.9) 390 (11.2) 379 (11.7) Pneumology 164 (3.4) 107 (3.1) 100 (3.1) Medicine, other 125 (2.6) 83 (2.4) 77 (2.4) Neonatal Intensive Care 92 (1.9) 82 (2.4) 82 (2.5) Obstetrics 27 (0.6) 14 (0.4) 14 (0.4) Otorhinolaryngology 2 (0.0) 0 (0.0) 0 (0.0) Pediatrics 112 (2.3) 53 (1.5) 52 (1.6) Psychiatry 15 (0.3) 10 (0.3) 10 (0.3) Revalidation 107 (2.2) 93 (2.7) 88 (2.7) Trauma/Emergency 271 (5.6) 16 (0.5) 11 (0.3) Other types 126 (2.6) 56 (1.6) 52 (1.6) TOTAL 4876 (100) 3471 (100) 3231 (100) *NSIHwin only Page 7 Table3

8 Table 4: Clinical data a. Demographics of patients with septicemia 1. Age and gender N % mean age min P25 P50 P75 max Female Male Total Patient origin at admission* N % Other hospital Nursing home Community Total Total NSIHwin data 4918 Missing origin b. Status at end of follow-up (in hospital) 1. Outcome and relationship septicemia to death Outcome <=7 d after SEP (%)(1) >7d after SEP (%)(1) Tot + disch.date (%)(2) Total (%)(2) Alive 683 (19.3) 2861 (80.7) 3544 (76.1) 3589 (76.2) Death 412 (37.0) 701 (63.0) 1113 (23.9) 1121 (23.8) Relationship septicemia to death (NSIHwin) Relationship not verified 155 (34.4) 295 (65.6) 450 (10.1) 451 (9.8) Not related 82 (23.8) 262 (76.2) 344 (7.7) 345 (7.5) Possible relationship 92 (49.2) 95 (50.8) 187 (4.3) 192 (4.2) Definite relationship 66 (74.2) 23 (25.8) 89 (2.0) 90 (2.0) (1) row percentage - (2) column percentage 95%CI Crude mortality (case fatality) rate 23.90% ( ) Mortality % in nosocomial(>d2) SEP % ( ) Mortality % within 7 days after noso-sep 10.10% ( ) Mortality % poss/defin. related to noso-sep 11.40% ( ) 2. Age and sex specific mortality N deaths (mortality %)(2) Age group N(1) F M Total <1 y (12.2) 9 (8.2) 20 (10.0) 1-4 y 76 1 (3.6) 0 (0.0) 1 (1.3) 5-14 y 51 1 (5.3) 2 (6.3) 3 (5.9) y (6.3) 2 (3.1) 7 (4.9) y (11.3) 12 (16.2) 18 (14.2) y (12.9) 20 (12.6) 38 (12.8) y (23.2) 88 (25.6) 143 (24.6) y (20.3) 128 (24.1) 188 (22.8) y (28.5) 212 (29.3) 361 (29.0) y (29.9) 155 (30.2) 311 (30.0) 90+ y (27.1) 8 (25.0) 31 (26.5) Total (23.4) 636 (24.2) 1121 (23.9) (1) Total number of patients in age group (2) N of deaths by sex and age - N of patients in cell=n deaths(% mortality) Page 8 Table4

9 c. Clinical symptoms* age <12m % age >=12m % total % Missing % % % Unknown % % % Fever % % % Chills 2 0.8% % % Hypotension 1 0.4% % % Hypothermia % 0 0.0% % Apnea % 0 0.0% % Bradycardia % 0 0.0% % *NSIHwin only Page 9 Table4

10 Table 5a : Distribution of micro-organisms A. Grouped, in decreasing order of frequency Escherichia spp % Coagulase-neg. staphylococci % Staphylococcus aureus % Streptococcus spp % Klebsiella spp % Enterococcus spp % Pseudomonas spp % Enterobacter spp % Candida spp % Proteus spp % Acinetobacter spp % Bacteroides spp % Serratia spp % Morganella spp % Other/unidentified % Citrobacter spp % Salmonella spp % Haemophilus spp % Stenotrophomonas spp % Neisseria spp % Clostridium spp % Corynebacterium spp % Providencia spp % Saccharomyces spp % Bacillus spp % Fusobacterium spp % Moraxella spp % Peptostreptococcus spp % Aeromonas spp % Listeria spp % Lactobacillus spp % Aerococcus spp % Campylobacter spp % Micrococcus spp % Peptococcus spp % Prevotella spp % Stomatococcus spp % Abiotrophia spp % Burkholderia spp % Capnocytophagia spp % Chryseobacterium spp % Entamoeba spp % Flavobacterium spp % Gemella spp % Other/unspec. yeast % Propionibacterium spp % Achromobacter spp % Actinomyces spp % Agrobacterium spp % Comamomas spp % Cryptococcus spp % Hafnia spp % Leuconostoc spp % Other gram-neg. bacilli, non-ferm % Other gram-pos. aerobic bacilli % Other gram-pos. cocci, aerobic % Pasteurella spp % Total % B. Detailed, in alphabetic order Page 10 Table5a

11 ABIOTROPHIA ADIACENS % ACHROMOBACTER XYLOSOXIDANS % ACINETOBACTER BAUMANNII % ACINETOBACTER CALCOACETICUS % ACINETOBACTER HAEMOLYTICUS % ACINETOBACTER JOHNSONII % ACINETOBACTER JUNII % ACINETOBACTER LWOFFI % ACINETOBACTER SPECIES, NOT SPECIFIED % ACTINOMYCES NAESLUNDII % AEROCOCCUS SPECIES, NOT SPECIFIED % AEROCOCCUS VIRIDANS % AEROMONAS HYDROPHILA % AGROBACTERIUM RADIOBACTER % ANAEROBES, NOT SPECIFIED % ARCANOBACTERIUM HAEMOLYTICUM % BACILLUS CEREUS % BACILLUS SPECIES, NOT SPECIFIED % BACTEROIDES AMYLOPHILUS % BACTEROIDES CAPILLOSUS % BACTEROIDES EGGERTHII % BACTEROIDES FRAGILIS % BACTEROIDES OVATUS % BACTEROIDES RUMINICOLA SUBSPECIES BREVIS % BACTEROIDES SPECIES, NOT SPECIFIED % BACTEROIDES THETAIOTAOMICRON % BACTEROIDES UNIFORMIS % BACTEROIDES VULGATUS % BIFIDOBACTERIUM SPECIES, NOT SPECIFIED % BURKHOLDERIA CEPACIA % CAMPYLOBACTER JEJUNI % CAMPYLOBACTER SPECIES, NOT SPECIFIED % CANDIDA ALBICANS % CANDIDA GLABRATA % CANDIDA GUILLIERMONDII % CANDIDA KEFYR % CANDIDA KRUSEI % CANDIDA LUSITANIAE % CANDIDA PARAPSILOSIS % CANDIDA SPECIES, NOT SPECIFIED % CANDIDA TROPICALIS % CAPNOCYTOPHAGIA SPECIES, NOT SPECIFIED % CAPNOCYTOPHAGIA SPUTIGENA % CHROMOBACTERIUM SPECIES, NOT SPECIFIED % CHRYSEOBACTERIUM MENINGOSEPTICUM % CHRYSEOBACTERIUM SPECIES, NOT SPECIFIED % CITROBACTER BRAAKII % CITROBACTER DIVERSUS % CITROBACTER FREUNDII % CITROBACTER SPECIES, NOT SPECIFIED % CLOSTRIDIUM DIFFICILE % CLOSTRIDIUM PERFRINGENS % CLOSTRIDIUM SPECIES, NOT SPECIFIED % CLOSTRIDIUM TETANI % COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPECIFIED % COMAMOMAS ACIDOVORANS % CORYNEBACTERIUM JEIKEIUM % CORYNEBACTERIUM PSEUDODIPHTERITICUM % CORYNEBACTERIUM SPECIES, NOT SPECIFIED % CORYNEBACTERIUM XEROSIS % CRYPTOCOCCUS NEOFORMANS % ECHINOCOCCUS GRANULOSUS % Page 11 Table5a

12 ENDOLIMAX NANA % ENTAMOEBA COLI % ENTAMOEBA HISTOLYTICA % ENTEROBACTER AEROGENES % ENTEROBACTER AMNIGENUS % ENTEROBACTER CLOACAE % ENTEROBACTER SAKAZAKII % ENTEROBACTER SPECIES, NOT SPECIFIED % ENTEROBIUS SPECIES, NOT SPECIFIED % ENTEROCOCCUS AVIUM % ENTEROCOCCUS DURANS % ENTEROCOCCUS FAECALIS % ENTEROCOCCUS FAECIUM % ENTEROCOCCUS SPECIES, NOT SPECIFIED % ENTEROPATHOGENIC ESCHERICHIA COLI % ERYSIPELOTHRIX RHUSIOPATHIAE % ESCHERICHIA COLI % FLAVOBACTERIUM INDOLOGENES % FLAVOBACTERIUM SPECIES, NOT SPECIFIED % FUSARIUM SPECIES % FUSOBACTERIUM NECROPHORUM % FUSOBACTERIUM NUCLEATUM % FUSOBACTERIUM SPECIES, NOT SPECIFIED % G-BAC, NON ENTEROBACTERIACEAE, NOT SPEC % GEMELLA MORBILLORUM % GEMELLA SPECIES, NOT SPECIFIED % GRAM NEGATIVE COCCI, NOT SPECIFIED % GRAM POSITIVE BACILLI, NOT SPECIFIED % GRAM POSITIVE COCCI, NOT SPECIFIED % HAEMOPHILUS AEGYPTIUS % HAEMOPHILUS APHROPHILUS % HAEMOPHILUS INFLUENZAE % HAFNIA ALVEI % KINGELLA KINGAE % KLEBSIELLA ORNITHINOLYTICA % KLEBSIELLA OXYTOCA % KLEBSIELLA OZAENAE % KLEBSIELLA PNEUMONIAE % KLEBSIELLA SPECIES, NOT SPECIFIED % LACTOBACILLUS SPECIES, NOT SPECIFIED % LEPTOTRICHIA SPECIES, NOT SPECIFIED % LEUCONOSTOC SPECIES % LISTERIA MONOCYTOGENES % LISTERIA SPECIES, NOT SPECIFIED % MICRO-ORGANISM NOT IDENTIFIED OR NOT FOUND % MICROCOCCUS SPECIES % MORAXELLA CATARRHALIS % MORAXELLA SPECIES, NOT SPECIFIED % MORGANELLA MORGANII % NEISSERIA GONORRHOEAE % NEISSERIA MENINGITIDIS % NEISSERIA SPECIES, NOT SPECIFIED % NUTRITIONNALY VARIANT STREPTOCOCCI % OTHER BACTERIA, NOT SPECIFIED % PANTOEA AGGLOMERANS % PASTEURELLA MULTOCIDA % PEPTOCOCCUS SPECIES, NOT SPECIFIED % PEPTOSTREPTOCOCCUS ANAEROBIUS % PEPTOSTREPTOCOCCUS MICROS % PEPTOSTREPTOCOCCUS SPECIES, NOT SPECIFIED % PREVOTELLA MELANINOGENICA % PREVOTELLA ORALIS % Page 12 Table5a

13 PROPIONIBACTERIUM ACNES % PROPIONIBACTERIUM SPECIES, NOT SPECIFIED % PROTEUS MIRABILIS % PROTEUS SPECIES, NOT SPECIFIED % PROTEUS VULGARIS % PROVIDENCIA RETTGERI % PROVIDENCIA SPECIES, NOT SPECIFIED % PROVIDENCIA STUARTII % PSEUDOMONAS AERUGINOSA % PSEUDOMONAS DIMINUTA % PSEUDOMONAS MALTOPHILIA % PSEUDOMONAS PAUCIMOBILIS % PSEUDOMONAS PUTIDA % PSEUDOMONAS SPECIES, NOT SPECIFIED % PSEUDOMONAS STUTZERI % PSEUDOMONAS VESICULARIS % RHODOTORULA SPECIES, NOT SPECIFIED % ROTHIA SPECIES, NOT SPECIFIED % SACCHAROMYCES CEREVISIAE % SALMONELLA ENTERITIDIS % SALMONELLA OF GROUP B % SALMONELLA OF GROUP C % SALMONELLA OF GROUP D % SALMONELLA PARATYPHI A % SALMONELLA SPECIES, NOT SPECIFIED % SALMONELLA STANLEY % SALMONELLA TYPHI % SALMONELLA TYPHIMURIUM % SERRATIA LIQUEFACIENS % SERRATIA MARCESCENS % SERRATIA SPECIES, NOT SPECIFIED % SPHINGOBACTERIUM SPECIES, NOT SPECIFIED % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS AURICULARIS % STAPHYLOCOCCUS CAPITIS % STAPHYLOCOCCUS COHNII % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS HAEMOLYTICUS % STAPHYLOCOCCUS HOMINIS % STAPHYLOCOCCUS LENTUS % STAPHYLOCOCCUS SACCHAROLYTICUS % STAPHYLOCOCCUS SAPROPHYTICUS % STAPHYLOCOCCUS SCHLEIFERI % STAPHYLOCOCCUS SPECIES, NOT SPECIFIED % STAPHYLOCOCCUS WARNERI % STAPHYLOCOCCUS XYLOSUS % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STENOTROPHOMONAS MALTOPHILIA % STOMATOCOCCUS MUCILAGINOSUS % STREPTOCOCCI, ALPHA-HEMOLYTIC % STREPTOCOCCI, BETA-HEMOLYTIC % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP A % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP B % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP C % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP F % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP G % STREPTOCOCCI, GAMMA-HEMOLYTIC % STREPTOCOCCUS ACIDOMINIMUS % STREPTOCOCCUS AGALACTIAE % STREPTOCOCCUS ANGINOSUS % STREPTOCOCCUS BOVIS % STREPTOCOCCUS MILLERI % Page 13 Table5a

14 STREPTOCOCCUS MITIS % STREPTOCOCCUS OF GROUP D % STREPTOCOCCUS PNEUMONIAE % STREPTOCOCCUS PYOGENES % STREPTOCOCCUS SALIVARIUS % STREPTOCOCCUS SANGUIS % STREPTOCOCCUS SPECIES, NOT SPECIFIED % STREPTOCOCCUS SUIS % STREPTOCOCCUS VIRIDANS % STREPTOMYCES SPECIES % YEASTS % Total % Page 14 Table5a

15 Table 5b : Distribution of micro-organisms by service A. Grouped, in decreasing order of frequency Burn Coagulase-neg. staphylococci % Total % General/abdom surg. Escherichia spp % Coagulase-neg. staphylococci % Klebsiella spp % Staphylococcus aureus % Enterobacter spp % Enterococcus spp % Streptococcus spp % Candida spp % Pseudomonas spp % Bacteroides spp % Proteus spp % Serratia spp % Acinetobacter spp % Morganella spp % Clostridium spp % Fusobacterium spp % Other/unidentified % Salmonella spp % Stenotrophomonas spp % Aeromonas spp % Bacillus spp % Citrobacter spp % Flavobacterium spp % Other gram-pos. aerobic bacilli % Providencia spp % Total % Cardiovasc.surg Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Klebsiella spp % Enterobacter spp % Pseudomonas spp % Enterococcus spp % Serratia spp % Streptococcus spp % Proteus spp % Candida spp % Morganella spp % Acinetobacter spp % Entamoeba spp % Other/unspec. yeast % Salmonella spp % Total % Page 15 Table5b-A

16 Mixed surgical/medic Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Klebsiella spp % Streptococcus spp % Candida spp % Enterobacter spp % Enterococcus spp % Acinetobacter spp % Other/unidentified % Proteus spp % Haemophilus spp % Serratia spp % Achromobacter spp % Bacteroides spp % Burkholderia spp % Campylobacter spp % Neisseria spp % Pseudomonas spp % Saccharomyces spp % Salmonella spp % Total % Neurosurgery Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Klebsiella spp % Enterobacter spp % Enterococcus spp % Providencia spp % Pseudomonas spp % Candida spp % Morganella spp % Proteus spp % Stenotrophomonas spp % Streptococcus spp % Total % Orthopedics Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Streptococcus spp % Candida spp % Acinetobacter spp % Enterobacter spp % Klebsiella spp % Proteus spp % Pseudomonas spp % Enterococcus spp % Citrobacter spp % Peptostreptococcus spp % Serratia spp % Page 16 Table5b-A

17 Total % Plastic surgery Coagulase-neg. staphylococci % Candida spp % Enterococcus spp % Escherichia spp % Klebsiella spp % Total % Urology Escherichia spp % Klebsiella spp % Staphylococcus aureus % Streptococcus spp % Coagulase-neg. staphylococci % Proteus spp % Enterococcus spp % Pseudomonas spp % Bacteroides spp % Enterobacter spp % Providencia spp % Acinetobacter spp % Candida spp % Haemophilus spp % Moraxella spp % Neisseria spp % Serratia spp % Stenotrophomonas spp % Total % Other surgery Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Enterococcus spp % Klebsiella spp % Enterobacter spp % Streptococcus spp % Proteus spp % Pseudomonas spp % Total % Geriatrics Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Streptococcus spp % Klebsiella spp % Enterococcus spp % Proteus spp % Candida spp % Enterobacter spp % Pseudomonas spp % Acinetobacter spp % Page 17 Table5b-A

18 Bacteroides spp % Serratia spp % Citrobacter spp % Morganella spp % Other/unidentified % Saccharomyces spp % Haemophilus spp % Salmonella spp % Aerococcus spp % Bacillus spp % Campylobacter spp % Clostridium spp % Corynebacterium spp % Fusobacterium spp % Micrococcus spp % Peptostreptococcus spp % Propionibacterium spp % Providencia spp % Stomatococcus spp % Total % Gynecology Escherichia spp % Staphylococcus aureus % Streptococcus spp % Acinetobacter spp % Bacteroides spp % Enterobacter spp % Enterococcus spp % Klebsiella spp % Neisseria spp % Other/unidentified % Peptostreptococcus spp % Total % Intensive care Coagulase-neg. staphylococci % Escherichia spp % Enterococcus spp % Pseudomonas spp % Staphylococcus aureus % Klebsiella spp % Candida spp % Streptococcus spp % Enterobacter spp % Bacteroides spp % Serratia spp % Morganella spp % Proteus spp % Acinetobacter spp % Citrobacter spp % Other/unidentified % Neisseria spp % Stenotrophomonas spp % Clostridium spp % Page 18 Table5b-A

19 Corynebacterium spp % Peptococcus spp % Providencia spp % Salmonella spp % Aerococcus spp % Burkholderia spp % Capnocytophagia spp % Chryseobacterium spp % Flavobacterium spp % Haemophilus spp % Lactobacillus spp % Moraxella spp % Peptostreptococcus spp % Saccharomyces spp % Total % Cardiology Escherichia spp % Staphylococcus aureus % Streptococcus spp % Coagulase-neg. staphylococci % Klebsiella spp % Enterococcus spp % Enterobacter spp % Acinetobacter spp % Candida spp % Proteus spp % Pseudomonas spp % Other/unidentified % Serratia spp % Morganella spp % Cryptococcus spp % Fusobacterium spp % Micrococcus spp % Providencia spp % Salmonella spp % Stomatococcus spp % Total % Endocrinology Staphylococcus aureus % Acinetobacter spp % Coagulase-neg. staphylococci % Escherichia spp % Aeromonas spp % Bacillus spp % Comamomas spp % Pasteurella spp % Salmonella spp % Total % Internal Medicine Escherichia spp % Coagulase-neg. staphylococci % Staphylococcus aureus % Page 19 Table5b-A

20 Streptococcus spp % Klebsiella spp % Enterococcus spp % Enterobacter spp % Pseudomonas spp % Candida spp % Proteus spp % Bacteroides spp % Acinetobacter spp % Citrobacter spp % Serratia spp % Other/unidentified % Clostridium spp % Listeria spp % Salmonella spp % Aeromonas spp % Haemophilus spp % Morganella spp % Neisseria spp % Abiotrophia spp % Actinomyces spp % Corynebacterium spp % Gemella spp % Moraxella spp % Peptostreptococcus spp % Propionibacterium spp % Saccharomyces spp % Stenotrophomonas spp % Stomatococcus spp % Total % Nephrology Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Enterococcus spp % Klebsiella spp % Enterobacter spp % Streptococcus spp % Pseudomonas spp % Candida spp % Acinetobacter spp % Haemophilus spp % Proteus spp % Serratia spp % Citrobacter spp % Fusobacterium spp % Morganella spp % Peptostreptococcus spp % Salmonella spp % Stenotrophomonas spp % Total % Oncology/Hematology Coagulase-neg. staphylococci % Page 20 Table5b-A

21 Escherichia spp % Staphylococcus aureus % Streptococcus spp % Enterococcus spp % Pseudomonas spp % Klebsiella spp % Enterobacter spp % Candida spp % Acinetobacter spp % Bacteroides spp % Serratia spp % Stenotrophomonas spp % Proteus spp % Citrobacter spp % Bacillus spp % Clostridium spp % Corynebacterium spp % Neisseria spp % Other/unidentified % Lactobacillus spp % Moraxella spp % Morganella spp % Prevotella spp % Abiotrophia spp % Aerococcus spp % Aeromonas spp % Agrobacterium spp % Capnocytophagia spp % Chryseobacterium spp % Fusobacterium spp % Leuconostoc spp % Micrococcus spp % Other gram-neg. bacilli, non-ferm % Other gram-pos. cocci, aerobic % Saccharomyces spp % Salmonella spp % Total % Pneumology Escherichia spp % Streptococcus spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Candida spp % Pseudomonas spp % Enterococcus spp % Klebsiella spp % Acinetobacter spp % Serratia spp % Enterobacter spp % Bacteroides spp % Salmonella spp % Other/unidentified % Proteus spp % Total % Page 21 Table5b-A

22 Medicine, other Escherichia spp % Coagulase-neg. staphylococci % Klebsiella spp % Staphylococcus aureus % Streptococcus spp % Enterobacter spp % Pseudomonas spp % Enterococcus spp % Candida spp % Proteus spp % Acinetobacter spp % Serratia spp % Campylobacter spp % Listeria spp % Morganella spp % Neisseria spp % Total % Neonatal Intensive Care Coagulase-neg. staphylococci % Staphylococcus aureus % Enterococcus spp % Escherichia spp % Klebsiella spp % Streptococcus spp % Enterobacter spp % Candida spp % Acinetobacter spp % Corynebacterium spp % Haemophilus spp % Proteus spp % Pseudomonas spp % Total % Obstetrics Escherichia spp % Streptococcus spp % Staphylococcus aureus % Enterococcus spp % Other/unidentified % Klebsiella spp % Neisseria spp % Peptococcus spp % Prevotella spp % Proteus spp % Pseudomonas spp % Total % Otorhinolaryngology Coagulase-neg. staphylococci % Escherichia spp % Total % Page 22 Table5b-A

23 Pediatrics Streptococcus spp % Escherichia spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Enterobacter spp % Klebsiella spp % Pseudomonas spp % Enterococcus spp % Haemophilus spp % Candida spp % Citrobacter spp % Corynebacterium spp % Lactobacillus spp % Neisseria spp % Other/unidentified % Proteus spp % Salmonella spp % Total % Psychiatry Coagulase-neg. staphylococci % Escherichia spp % Klebsiella spp % Streptococcus spp % Enterobacter spp % Enterococcus spp % Salmonella spp % Stenotrophomonas spp % Total % Revalidation Escherichia spp % Coagulase-neg. staphylococci % Staphylococcus aureus % Proteus spp % Streptococcus spp % Klebsiella spp % Bacteroides spp % Candida spp % Pseudomonas spp % Enterobacter spp % Acinetobacter spp % Entamoeba spp % Enterococcus spp % Moraxella spp % Other/unspec. yeast % Total % Trauma/Emergency Escherichia spp % Streptococcus spp % Staphylococcus aureus % Coagulase-neg. staphylococci % Klebsiella spp % Page 23 Table5b-A

24 Enterococcus spp % Proteus spp % Pseudomonas spp % Other/unidentified % Citrobacter spp % Enterobacter spp % Acinetobacter spp % Candida spp % Haemophilus spp % Bacteroides spp % Gemella spp % Hafnia spp % Listeria spp % Providencia spp % Salmonella spp % Serratia spp % Total % Other types Escherichia spp % Staphylococcus aureus % Streptococcus spp % Coagulase-neg. staphylococci % Enterococcus spp % Klebsiella spp % Enterobacter spp % Pseudomonas spp % Acinetobacter spp % Bacteroides spp % Citrobacter spp % Morganella spp % Proteus spp % Candida spp % Clostridium spp % Haemophilus spp % Serratia spp % Total % Page 24 Table5b-A

25 B. Detailed, in alphabetic order Burn STAPHYLOCOCCUS EPIDERMIDIS % Total % General/abdom surg. ACINETOBACTER BAUMANNII % ACINETOBACTER HAEMOLYTICUS % ACINETOBACTER LWOFFI % ACINETOBACTER SPECIES, NOT SPECIFIED % AEROMONAS HYDROPHILA % BACILLUS CEREUS % BACTEROIDES FRAGILIS % BACTEROIDES RUMINICOLA SUBSPECIES BREVIS % BACTEROIDES SPECIES, NOT SPECIFIED % CANDIDA ALBICANS % CANDIDA GLABRATA % CANDIDA KEFYR % CANDIDA PARAPSILOSIS % CANDIDA SPECIES, NOT SPECIFIED % CITROBACTER FREUNDII % CLOSTRIDIUM SPECIES, NOT SPECIFIED % CLOSTRIDIUM TETANI % COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPE % ENTEROBACTER AEROGENES % ENTEROBACTER CLOACAE % ENTEROCOCCUS AVIUM % ENTEROCOCCUS FAECALIS % ENTEROCOCCUS FAECIUM % ENTEROCOCCUS SPECIES, NOT SPECIFIED % ERYSIPELOTHRIX RHUSIOPATHIAE % ESCHERICHIA COLI % FLAVOBACTERIUM SPECIES, NOT SPECIFIED % FUSOBACTERIUM NUCLEATUM % GRAM POSITIVE BACILLI, NOT SPECIFIED % KLEBSIELLA ORNITHINOLYTICA % KLEBSIELLA OXYTOCA % KLEBSIELLA PNEUMONIAE % MICRO-ORGANISM NOT IDENTIFIED OR NOT FOU % MORGANELLA MORGANII % PROTEUS MIRABILIS % PROTEUS SPECIES, NOT SPECIFIED % PROVIDENCIA STUARTII % PSEUDOMONAS AERUGINOSA % PSEUDOMONAS DIMINUTA % PSEUDOMONAS PAUCIMOBILIS % PSEUDOMONAS STUTZERI % SALMONELLA TYPHI % SALMONELLA TYPHIMURIUM % SERRATIA MARCESCENS % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS CAPITIS % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS HAEMOLYTICUS % Page 25 Table5b-B

26 STAPHYLOCOCCUS HOMINIS % STAPHYLOCOCCUS SACCHAROLYTICUS % STAPHYLOCOCCUS SCHLEIFERI % STAPHYLOCOCCUS SPECIES, NOT SPECIFIED % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STENOTROPHOMONAS MALTOPHILIA % STREPTOCOCCI, BETA-HEMOLYTIC % STREPTOCOCCUS AGALACTIAE % STREPTOCOCCUS ANGINOSUS % STREPTOCOCCUS BOVIS % STREPTOCOCCUS MILLERI % STREPTOCOCCUS MITIS % STREPTOCOCCUS PNEUMONIAE % STREPTOCOCCUS SPECIES, NOT SPECIFIED % STREPTOCOCCUS VIRIDANS % Total % Cardiovasc.surg ACINETOBACTER BAUMANNII % CANDIDA GLABRATA % CANDIDA PARAPSILOSIS % COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPE % ENTAMOEBA HISTOLYTICA % ENTEROBACTER AEROGENES % ENTEROBACTER CLOACAE % ENTEROBACTER SPECIES, NOT SPECIFIED % ENTEROCOCCUS FAECALIS % ESCHERICHIA COLI % KLEBSIELLA OXYTOCA % KLEBSIELLA PNEUMONIAE % MORGANELLA MORGANII % PROTEUS MIRABILIS % PROTEUS VULGARIS % PSEUDOMONAS AERUGINOSA % SALMONELLA STANLEY % SERRATIA MARCESCENS % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS HAEMOLYTICUS % STAPHYLOCOCCUS SPECIES, NOT SPECIFIED % STAPHYLOCOCCUS XYLOSUS % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP A % STREPTOCOCCUS AGALACTIAE % STREPTOCOCCUS BOVIS % STREPTOCOCCUS PNEUMONIAE % STREPTOCOCCUS PYOGENES % YEASTS % Total % Mixed surgical/medic ACHROMOBACTER XYLOSOXIDANS % ACINETOBACTER BAUMANNII % ACINETOBACTER HAEMOLYTICUS % ACINETOBACTER SPECIES, NOT SPECIFIED % Page 26 Table5b-B

27 BACTEROIDES SPECIES, NOT SPECIFIED % BURKHOLDERIA CEPACIA % CAMPYLOBACTER JEJUNI % CANDIDA ALBICANS % CANDIDA GLABRATA % CANDIDA GUILLIERMONDII % CANDIDA PARAPSILOSIS % CANDIDA TROPICALIS % COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPE % ENTEROBACTER AEROGENES % ENTEROBACTER CLOACAE % ENTEROBIUS SPECIES, NOT SPECIFIED % ENTEROCOCCUS FAECALIS % ESCHERICHIA COLI % HAEMOPHILUS INFLUENZAE % KLEBSIELLA OXYTOCA % KLEBSIELLA PNEUMONIAE % MICRO-ORGANISM NOT IDENTIFIED OR NOT FOU % NEISSERIA MENINGITIDIS % PANTOEA AGGLOMERANS % PROTEUS MIRABILIS % PSEUDOMONAS AERUGINOSA % SACCHAROMYCES CEREVISIAE % SALMONELLA PARATYPHI A % SERRATIA MARCESCENS % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS HOMINIS % STAPHYLOCOCCUS SPECIES, NOT SPECIFIED % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP A % STREPTOCOCCUS ACIDOMINIMUS % STREPTOCOCCUS BOVIS % STREPTOCOCCUS MITIS % STREPTOCOCCUS PNEUMONIAE % STREPTOCOCCUS PYOGENES % STREPTOCOCCUS VIRIDANS % Total % Neurosurgery CANDIDA ALBICANS % ENTEROBACTER AEROGENES % ENTEROBACTER CLOACAE % ENTEROCOCCUS FAECALIS % ENTEROCOCCUS SPECIES, NOT SPECIFIED % ESCHERICHIA COLI % KLEBSIELLA OXYTOCA % KLEBSIELLA PNEUMONIAE % MORGANELLA MORGANII % PROTEUS MIRABILIS % PROVIDENCIA SPECIES, NOT SPECIFIED % PROVIDENCIA STUARTII % PSEUDOMONAS AERUGINOSA % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS EPIDERMIDIS % Page 27 Table5b-B

28 STAPHYLOCOCCUS WARNERI % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STENOTROPHOMONAS MALTOPHILIA % STREPTOCOCCUS PNEUMONIAE % Total % Orthopedics ACINETOBACTER BAUMANNII % ACINETOBACTER HAEMOLYTICUS % ACINETOBACTER LWOFFI % CANDIDA ALBICANS % CANDIDA PARAPSILOSIS % CANDIDA TROPICALIS % CITROBACTER FREUNDII % COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPE % ENTEROBACTER AEROGENES % ENTEROBACTER CLOACAE % ENTEROCOCCUS FAECALIS % ENTEROCOCCUS FAECIUM % ESCHERICHIA COLI % KLEBSIELLA ORNITHINOLYTICA % KLEBSIELLA OXYTOCA % KLEBSIELLA PNEUMONIAE % PEPTOSTREPTOCOCCUS SPECIES, NOT SPECIFIE % PROTEUS MIRABILIS % PROTEUS SPECIES, NOT SPECIFIED % PROTEUS VULGARIS % PSEUDOMONAS AERUGINOSA % SERRATIA MARCESCENS % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS CAPITIS % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STREPTOCOCCUS BOVIS % STREPTOCOCCUS OF GROUP D % STREPTOCOCCUS PNEUMONIAE % STREPTOCOCCUS PYOGENES % STREPTOCOCCUS SANGUIS % STREPTOCOCCUS VIRIDANS % Total % Plastic surgery CANDIDA GLABRATA % ENTEROCOCCUS FAECALIS % ESCHERICHIA COLI % KLEBSIELLA PNEUMONIAE % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS HAEMOLYTICUS % STAPHYLOCOCCUS HOMINIS % Total % Urology ACINETOBACTER BAUMANNII % BACTEROIDES FRAGILIS % CANDIDA ALBICANS % Page 28 Table5b-B

29 COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPE % ENTEROBACTER AEROGENES % ENTEROBACTER CLOACAE % ENTEROCOCCUS FAECALIS % ENTEROCOCCUS FAECIUM % ESCHERICHIA COLI % HAEMOPHILUS INFLUENZAE % KLEBSIELLA OXYTOCA % KLEBSIELLA PNEUMONIAE % MORAXELLA SPECIES, NOT SPECIFIED % NEISSERIA MENINGITIDIS % PROTEUS MIRABILIS % PROVIDENCIA RETTGERI % PSEUDOMONAS AERUGINOSA % SERRATIA MARCESCENS % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS CAPITIS % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STENOTROPHOMONAS MALTOPHILIA % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP A % STREPTOCOCCUS MITIS % STREPTOCOCCUS PNEUMONIAE % STREPTOCOCCUS VIRIDANS % Total % Other surgery COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPE % ENTEROBACTER AEROGENES % ENTEROCOCCUS FAECALIS % ENTEROCOCCUS SPECIES, NOT SPECIFIED % ESCHERICHIA COLI % KLEBSIELLA OXYTOCA % KLEBSIELLA PNEUMONIAE % PROTEUS MIRABILIS % PSEUDOMONAS AERUGINOSA % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS CAPITIS % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STREPTOCOCCUS BOVIS % STREPTOCOCCUS SUIS % Total % Geriatrics ACINETOBACTER BAUMANNII % ACINETOBACTER SPECIES, NOT SPECIFIED % AEROCOCCUS VIRIDANS % ANAEROBES, NOT SPECIFIED % BACILLUS CEREUS % BACTEROIDES FRAGILIS % BACTEROIDES SPECIES, NOT SPECIFIED % BACTEROIDES UNIFORMIS % BACTEROIDES VULGATUS % CAMPYLOBACTER SPECIES, NOT SPECIFIED % Page 29 Table5b-B

30 CANDIDA ALBICANS % CANDIDA GLABRATA % CANDIDA SPECIES, NOT SPECIFIED % CANDIDA TROPICALIS % CITROBACTER BRAAKII % CITROBACTER DIVERSUS % CITROBACTER FREUNDII % CITROBACTER SPECIES, NOT SPECIFIED % CLOSTRIDIUM PERFRINGENS % COAGULASE-NEGATIVE STAFYLOCOCCI, NOT SPE % CORYNEBACTERIUM SPECIES, NOT SPECIFIED % ECHINOCOCCUS GRANULOSUS % ENTEROBACTER AEROGENES % ENTEROBACTER CLOACAE % ENTEROCOCCUS DURANS % ENTEROCOCCUS FAECALIS % ENTEROCOCCUS FAECIUM % ENTEROCOCCUS SPECIES, NOT SPECIFIED % ESCHERICHIA COLI % FUSOBACTERIUM NECROPHORUM % GRAM POSITIVE BACILLI, NOT SPECIFIED % HAEMOPHILUS INFLUENZAE % KLEBSIELLA OXYTOCA % KLEBSIELLA OZAENAE % KLEBSIELLA PNEUMONIAE % KLEBSIELLA SPECIES, NOT SPECIFIED % MICROCOCCUS SPECIES % MORGANELLA MORGANII % OTHER BACTERIA, NOT SPECIFIED % PEPTOSTREPTOCOCCUS ANAEROBIUS % PROPIONIBACTERIUM ACNES % PROTEUS MIRABILIS % PROTEUS SPECIES, NOT SPECIFIED % PROVIDENCIA STUARTII % PSEUDOMONAS AERUGINOSA % PSEUDOMONAS PAUCIMOBILIS % ROTHIA SPECIES, NOT SPECIFIED % SACCHAROMYCES CEREVISIAE % SALMONELLA ENTERITIDIS % SALMONELLA OF GROUP D % SALMONELLA TYPHIMURIUM % SERRATIA MARCESCENS % STAPHYLOCOCCUS AUREUS % STAPHYLOCOCCUS CAPITIS % STAPHYLOCOCCUS COHNII % STAPHYLOCOCCUS EPIDERMIDIS % STAPHYLOCOCCUS HAEMOLYTICUS % STAPHYLOCOCCUS HOMINIS % STAPHYLOCOCCUS SACCHAROLYTICUS % STAPHYLOCOCCUS SCHLEIFERI % STAPHYLOCOCCUS SPECIES, NOT SPECIFIED % STAPHYLOCOCCUS WARNERI % STAPHYLOCOCCUS, COAGULASE NEGATIVE % STOMATOCOCCUS MUCILAGINOSUS % STREPTOCOCCI, BETA-HEMOLYTIC OF GROUP B % Page 30 Table5b-B