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Abstract
Background
Cumulative blood culture data provide clinicians with important information in the selection of empiric therapy for blood stream infections.
Methods
We retrospectively analyzed blood culture data from a university hospital during the period from 2006 to 2015. Only the initial isolates of a given species for each patient were included.
Results
The number of blood cultures per 1,000 inpatient-days increased from 64 in 2006 to 117 in 2015. The ratio of significant pathogens to total isolates was 0.56-0.63. The most common organisms were Escherichia coli in 2006-2010 but changed to coagulase-negative staphylococci (CoNS) in 2011. The proportion of Staphylococci aureus was decreased during the study period, but Klebsiella pneumoniae was increased. Enterococci were increased, especially E. faecium, which was more frequently isolated than E. faecalis in 2015. Pseudomonas aeruginosa was decreased during the study, but Acinetobacter baumannii was increased. The prevalence of methicillin-resistant S. aureus (MRSA) changed from 62.2% to 53.9%, while vancomycin-resistant E. faecium increased to 35.8%. Extended-spectrum beta-lactamase (ESBL)-producing E. coli and K. pneumoniae increased to 25% and 34%, respectively, in 2015. Starting in 2008, three E. coli and 11 K. pneumoniae isolates were carbapenem-resistant Enterobacteriaceae (CRE), and three were carbapenemase-producing Enterobacteriaceae (CPE). The prevalence of imipenem-resistant A. baumannii rapidly increased during the study period.
Conclusion
About 60% of all blood isolates were significant pathogens. The most common isolates changed from E. coli to CoNS in 2011. ESBL-producing E. coli and K. pneumoniae, vancomycin-resistant E. faecium, and imipenem-resistant A. baumannii were increased during the study, while the proportion of MRSA tended to decrease slightly. Of the total isolates, 14 were CRE, and 3 were CPE.
Figures and Tables
Fig. 1
The number of Streptococcus pneumoniae and Streptococcus agalactiae isolated from blood culture.
Fig. 4
Resistance rates of Enterococci to ampicillin and vancomycin. Abbreviations: EFA, Enterococcus faecalis; EFM, Enterococcus faecium; AMP, ampicillin; VAN, vancomycin.
Fig. 5
Resistance rates of E. coli and K. pneumoniae to various antibiotics. Abbreviations: CIP, ciprofloxacin; CTX, cefotaxime; IMP, imipenem.
Fig. 6
Resistance rates of A. baumannii and P. aeruginosa to various antibiotics. Abbreviations: CIP, ciprofloxacin; IMP, imipenem; CAZ, ceftazidime.
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