Anton Y. Peleg, M.B., B.S., M.P.H., and David C. Hooper, M.D. NEJM Volume 362:1804-1813 May 13, 2010 Number 19
Hospital-acquired infections are a major challenge to patient safety. It is estimated that in 2002, a total of 1.7 million hospital-acquired infections occurred (4.5 per 100 admissions),1 and almost 99,000 deaths resulted from or were associated with a hospital-acquired infection,1 making hospital-acquired infections the sixth leading cause of death in the United States2; similar data have been reported from Europe.3 The estimated costs to the U.S. health care budget are $5 billion to $10 billion annually.4 Approximately one third or more of hospital-acquired infections are preventable.5

Infections caused by gram-negative bacteria have features that are of particular concern. These . . . [

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