Lab Med Online.  2019 Apr;9(2):63-72. 10.3343/lmo.2019.9.2.63.

Trends in Bloodstream Infections and Antimicrobial Susceptibilities at a University Hospital in Korea Between 2007 and 2016

• Lim S
• Yeom JS
• Joo EJ
• Cheong HS
• Lee K
• Woo HY
• Park H
• Kwon MJ

• KMID: 2441825
• DOI: http://doi.org/10.3343/lmo.2019.9.2.63

Abstract

BACKGROUND
Blood culture is an important method for identifying infectious microorganisms and confirming that a selected antimicrobial treatment is appropriate. In this study, we investigated the annual changes in the frequencies of blood isolates and antibiotic susceptibility test (AST) results.
METHODS
We created a large database comprising data on all patient-unique blood cultures obtained from January 2007 through December 2016. Blood specimens were cultured using the BD BACTEC FX system, and species identification and AST were performed using the VITEK 2 system.
RESULTS
During the 10-year study period, a total of 203,651 blood culture results were collected. Of these, gram-positive cocci, gram-negative rods, and fungi were isolated in 2.15%, 0.55%, and 0.12% of the blood cultures, respectively. Escherichia coli was the most commonly isolated species (22.8%), followed by Staphylococcus epidermidis (16.8%), Klebsiella pneumoniae (8.1%), and Staphylococcus aureus (8.0%). Fungal species were isolated in 3.0% of all positive blood cultures. Candida albicans was the most commonly isolated species (1.1%), followed by Candida parapsilosis (0.6%). Methicillin resistance was seen in 55.2% of S. aureus isolates. The frequencies of vancomycin-resistant Enterococcus (VRE) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) were 13.1% and 10.9%, respectively. The isolation rates of MRSA, VRE, and CRPA showed different patterns each year.
CONCLUSIONS
Among the isolates, E. coli was the most common, followed by S. epidermidis and K. pneumoniae. This study represents a long-term analysis of bloodstream infections, and the results can be used to identify trends in the microorganisms isolated and their drug resistance.

Keyword

Blood culture; Bacteremia; Identification; Antimicrobial susceptibility test

MeSH Terms

Bacteremia
Candida
Candida albicans
Drug Resistance
Enterococcus
Escherichia coli
Fungi
Gram-Positive Cocci
Klebsiella pneumoniae
Korea*
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Methods
Pneumonia
Pseudomonas aeruginosa
Staphylococcus aureus
Staphylococcus epidermidis

Figure

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  Fig. 1. Proportions of isolated organisms from blood cultures between 2007 and 2016.

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  Fig. 2. Proportion of isolated organisms from blood cultures according to department of medicine between 2007 and 2016. Abbreviations: ER, Emergency Room; MG, Medicine of Gastroenterology; MO, Medicine of Oncology; MN, Medicine of Nephrology; MC, Medicine of Cardiovascular; GS, General Surgery; NS, Neurological Surgery; MF, Medicine of Infectious Diseases; MR, Medicine of Respiratory.

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  Fig. 3. Ten-year trend of percent resistance to ciprofloxacin, oxacillin, rifampin, cotrimoxazole, and vancomycin for S. aureus. Abbreviations: CIP, ciprofloxacin; OXA, oxacillin; RIF, rifampin; SXT, cotrimoxazole; VAN, vancomycin; %R, % resistance.

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  Fig. 4. Ten-year trend of percent resistance to ampicillin and vancomycin for E. faecium and E. faecalis. Abbreviations: EFM, E. faecium; EFA, E. faecalis; AMP, ampicillin; VAN, vancomycin; %R, % resistance.

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  Fig. 5. Ten-year trend of percent resistance to third-generation cephalosporins and fluoroquinolone for E. coli and K. pneumoniae. Abbreviations: ECO, E. coli; KPN, K. pneumoniae; 3rd cepha, third-generation cephalosporins; FQ, fluoroquinolone; %R, % resistance.

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  Fig. 6. Ten-year trend of percent resistance to imipenem and fluoroquinolone for P. aeruginosa and A. baumannii. Abbreviations: PAE, P. aeruginosa; ABA, A. baumannii; IPM, imipenem; FQ, fluoroquinolone; %R, % resistance.

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