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초록
Background
Blood culture remains the definitive method for diagnosing bacteremia and fungemia. In this study, we investigated the incidence of bacterial and fungal infections along with the trends in antimicrobial susceptibility in blood cultures collected from 2008 to 2013.
Methods
We performed a retrospective analysis of blood cultures performed at Kyung Hee University Hospital, Seoul, South Korea, between 2008 and 2013 to determine the bacterial and fungal species isolated, and their antimicrobial susceptibilities. Additional analyses were performed comparing these results to that of a prior study examining blood cultures collected from 2003-2007.
Results
Of the 102,257 specimens collected, 8,452 (8.3%) were culture positive, with Staphylococcus ep-idermidis being the most common species isolated (17.3%), followed by Escherichia coli (16.9%), Staphylococcus aureus (8.1%), and Klebsiella pneumoniae (6.5%). Fungal species accounted for 3.7% of all isolates. Methicillin resistance was seen in 54.3% of S. aureus isolates. The frequencies of extended-spectrum β-lactamase (ESBL)-producing E. coli and K. pneumoniae were 13.1% and 10.3%; imipenem resistance was seen in 19.5% of Pseudomonas aeruginosa isolates.
Conclusion
Although the number of blood specimens analyzed increased steadily over the course of this study, the rate of positive blood cultures declined. The most common microorganisms isolated were co-agulase-negative staphylococci, E. coli, S. aureus, and K. pneumoniae, consistent with our prior analysis. This analysis of blood culture isolate frequencies and antibiotic susceptibilities can be used to inform antibiotic therapy decisions.
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Fig. 1.
Trends in antimicrobial resistance rates in S. aureus, E. coli, K. pneumoniae, E. faecium, P. aeruginosa and A. baumannii. Abbre-viations: MRSA, Methicillin-resistant S. aureus; ESBL ECO, Extended-spectrum β-lactamase-producing E. coli; ESBL KPN, Extended-spec-trum β-lactamase-producing K. pneumoniae; VRE, Vancomycin-re-sistant E. faecium; CRPA, Carbapenem-resistant P. aeruginosa; CRAB, Carbapenem-resistant A. baumannii.
Table 1.
Classes of bacteria and fungi isolated by year
Table 2.
Significant bacterial isolates by year
Table 3.
Fungal isolates trend
Table 4.
Trend of vancomycin and ampicillin resistance in E. faecalis and E. faecium
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