Journal List > Korean J Clin Microbiol > v.12(4) > 1038173

Kim, Lim, Kim, Suh, and Lee: Trends in Five-year Blood Cultures of Patients at a University Hospital (2003∼2007)

Abstract

Background

Blood culture is the definitive method for the diagnosis and treatment of bacteremia and fungemia. Analysis of blood cultures positive for pathogenic species and trends in antimicrobial susceptibility can help delineate appropriate and experimental treatment strategies. In this study, we investigated the incidence of pathogenic species and trends in antimicrobial susceptibility in blood cultures collected from 2003 to 2007 to help clinicians to determine the best methods of diagnosis and treatment. Changes between previously published analyses and this study were also investigated.

Methods

Five-year blood culture results obtained at Kyung Hee University Hospital between 2003 and 2007 were analyzed to determine the bacterial and fungal species present and the antimicrobial susceptibility of the isolates. Antimicrobial susceptibility was tested by the broth microdilution method and the CLSI disk diffusion method.

Results

Among the 66,437 blood cultures, 5,645 were positive. Of the positive blood cultures, 59.8% were positive for aerobic and facultative anaerobic gram-positive cocci. Coagulase-negative staphylococci (CoNS) were frequently isolated. The numbers of anaerobic species and fungi decreased over the years.

Conclusion

CoNS were the microorganisms most commonly isolated from blood cultures at Kyung Hee University Hospital. The number of cultures positive for fungi was higher than that reported in previous studies, but the absolute isolation rate over five years decreased. Anaerobic species were much less frequently isolated than reported for other hospitals.

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Fig. 1.
Trends in antimicrobial resistances (%) of E. coli, K. pneumoniae, S. aureus and E. faecium. Abbreviations: CXT R, cefotaxim-resistant; MET R, methicillin- resistant; VAN R, vancomycin-resistant.
kjcm-12-163f1.tif
Table 1.
Groups of bacteria and fungi isolated by year
Organisms N. of positive patients according to years
2003 2004 2005 2006 2007 2003∼2007 Total (%) 1986∼1996 Total (%)
Aerobic and facultative
 G (+) cocci 326 350 454 449 397 1,976 (59.82) 1,494 (42.0)
 G (−) cocci 1 0 1 3 0 5 (0.09) 1 (<1)
 G (+) bacilli 15 19 29 16 11 90 (2.72) 62 (1.7)
 G (−) bacilli 176 198 263 305 153 1,095 (33.15) 1,380 (38.8)
Anaerobic 0 0 0 1 0 1 (0.03) 31 (0.9)
Fungi 17 14 27 41 37 136 (4.12) 127 (3.6)
Total 518 567 747 774 561 3,303 (100.0) 3,559 (100)
Table 2.
Annual isolation of significant bacterial pathogens
Organisms Positive patients (%) according to years
2003 2004 2005 2006 2007 2003∼2007 Total (%) 1986∼1996 Total (%)
Staphylococcus aureus 73 (14.09) 93 (16.40) 79 (10.58) 135 (17.44) 50 (8.91) 430 (13.58) 530 (34.0)
Staphylococcus, coagulase negat tive 185 (35.71) 182 (32.10) 277 (37.08) 214 (27.65) 301 (53.65) 1,159 (36.60) 625 (40.1)
Streptococcus pneumoniae 8 (1.54) 13 (2.29) 4 (0.54) 5 (0.65) 8 (1.43) 38 (2.00) 61 (3.9)
α-hemolytic Streptococcus 7 (1.35) 9 (1.59) 8 (1.07) 8 (1.07) 6 (1.07) 38 (2.00) 96 (6.2)
β-hemolytic Streptococcus 2 (0.39) 5 (0.88) 1 (0.13) 1 (0.13) 0 (0) 9 (0.28) NA
Enterococcus faecalis 10 (1.93) 16 (2.82) 20 (2.68) 21 (2.71) 5 (0.89) 72 (2.27) NA
Enterococcus faecium 18 (3.47) 10 (1.76) 25 (3.35) 34 (4.39) 8 (1.43) 95 (3.00) NA
Escherichia coli 81 (15.64) 100 (17.64) 106 (14.19) 154 (19.90) 75 (13.37) 516 (16.30) 782 (55.0)
Salmonella typhi 1 (0.19) 1 (0.18) 1 (0.13) 2 (0.26) 1 (0.18) 6 (0.19) 69 (4.9)
Klebsiella pneumoniae 24 (4.63) 43 (7.58) 56 (7.50) 39 (5.04) 23 (4.10) 185 (5.84) 197 (13.9)
Enterobacter spp. 8 (1.54) 8 (1.41) 20 (2.68) 16 (2.07) 6 (1.07) 58 (1.83) 77 (5.4)
Serratia marcescens 4 (0.77) 3 (0.53) 5 (0.67) 8 (1.03) 1 (0.18) 21 (0.66) NA
Proteus spp. 2 (0.39) 1 (0.18) 2 (0.27) 8 (1.03) 4 (0.71) 17 (0.54) NA
Pseudomonas aeruginosa 13 (2.51) 9 (1.59) 14 (1.87) 15 (1.94) 11 (1.96) 62 (1.96) 145 (34.3)
Burkholderia cepacia 5 (0.97) 4 (0.71) 2 (0.27) 13 (1.68) 3 (0.53) 27 (0.85) 75 (17.7)
Total 518 (100.0) 567 (100.0) 747 (100.0) 774 (100.0) 561 (100.0) 3,167 (100.0) 3,559 (100.0)

Abbreviation: NA, not available.

Table 3.
Species of fungi isolated
Organisms N. of positive patients
2003∼2007 Total (%) 1986∼1996 Total (%)
Candida albicans 55 (40.44) 61 (48.0)
Candida tropicalis 47 (34.56) 21 (16.5)
Candida parapsilosis 12 (8.82) 22 (17.3)
Candida glabrata 15 (11.03) 8 (6.3)
Others 7 (5.15) 15 (11.8)
Total 136 (100.0) 127 (100.0)
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