Ann Clin Microbiol.  2023 Dec;26(4):147-157. 10.5145/ACM.2023.26.4.147.

Analysis of blood culture data in Korea: bacterial distribution and cumulative antimicrobial resistance (2016–2020)

Affiliations
  • 1Department of Laboratory Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea

Abstract

Background
The distribution of bacteria isolated from bloodstream infections and cumulative antimicrobial susceptibility data are the basis for empirical decisions regarding antibiotics as an initial treatment. Therefore, it is important to consistently collect blood culture results of individual patients and analyze them correctly.
Methods
The blood culture results of patients at a university hospital from 2016 to 2020 were analyzed retrospectively to determine the bacterial distributions and antibiotic resistance patterns. Duplicates were eliminated by including only the first isolate of each species per patient.
Results
Escherichia coli (27.1%) was the most commonly isolated bacterium from blood cultures, followed by Klebsiella pneumoniae (10.1%) and Staphylococcus aureus (8.6%). The methicillin resistance rate of S. aureus was 49.2%, and the vancomycin resistance rate of Enterococcus faecium was 39.5%; with no significant changes over the study period. The cefotaxime, ciprofloxacin, and ertapenem resistance rates of E. coli were 35.0%, 46.8%, and 0.7%, respectively. Seventeen carbapenem-resistant E. coli strains were isolated, of which 11 produced carbapenemase. The cefotaxime, ciprofloxacin, and ertapenem resistance rates of K. pneumoniae were 29.5%, 31.7%, and 5.4%, respectively. Forty-eight carbapenem-resistant K. pneumoniae strains were isolated, of which 37 produced carbapenemase. The imipenem resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa were 72.3% and 23.4%, respectively.
Conclusion
In the blood culture results from 2016 to 2020, the isolation frequency of E. coli, K. pneumoniae, and E. faecium showed an increasing trend, whereas that of S. aureus was stable. Over the 5 year study period, the ciprofloxacin resistance rate of E. coli and P.aeruginosa and ampicillin/sulbactam resistance rate of A. baumannii significantly increased.

Keyword

Blood culture; Bloodstream infection; Susceptibility

Reference

1. Ljungquist O, Blomstergren A, Merkel A, Sunnerhagen T, Holm K, Torisson G. Incidence, aetiology and temporal trend of bloodstream infections in southern Sweden from 2006 to 2019: a population-based study. Euro Surveill 2023;28:2200519. .
2. Shin JH, Song SA, Kim MN, Lee NY, Kim EC, Kim S, et al. Comprehensive analysis of blood culture performed at nine university hospitals in Korea. Korean J Lab Med 2011;31:101-6. .
3. Lim S, Yeom JS, Joo EJ, Cheong HS, Lee K, Woo HY, et al. Trends in bloodstream infections and antimicrobial susceptibilities at a university hospital in Korea between 2007 and 2016. Lab Med Online 2019;9:63-72. .
4. Kohlmann R and Gatermann SG. Analysis and presentation of cumulative antimicrobial susceptibility test data–the influence of different parameters in a routine clinical microbiology laboratory. PloS One 2016;11:e0147965. .
5. Clinical and Laboratory Standard Institute. Analysis and presentation of cumulative antimicrobial susceptibility test data. CLSI M39. 5th ed. Wayne, PA; CLSI: 2022. .
6. Seo YH, Jeong JH, Lee HT, Kwoun WJ, Park PW, Ahn JY, et al. Analysis of blood culture data at a tertiary university hospital, 2006-2015. Ann Clin Microbiol 2017;20:35-41. .
7. Clinical and Laboratory Standard Institute. Performance standards for antimicrobial susceptibility testing. CLSI M100. 30th ed, Wayne, PA; CLSI: 2020. .
8. WHO. WHONET 2022. The microbiology laboratory database software. https://whonet.org/ index.html [Online] (last visited on 17 November 2023). .
9. Doern GV, Carroll KC, Diekema DJ, Garey KW, Rupp ME, Weinstein MP, et al. Practical guidance for clinical microbiology laboratories: a comprehensive update on the problem of blood culture contamination and a discussion of methods for addressing the problem. Clin Microbiol Rev 2019;33:e00009-19. .
10. Bekeris LG, Tworek JA, Walsh MK, Valenstein PN. Trends in blood culture contamination: a College of American Pathologists Q-Tracks study of 356 institutions. Arch Pathol Lab Med 2005;129:1222-5. .
11. Alonso-Menchén D, Muñoz P, Sánchez-Carrillo C, Pérez-Latorre L, Bouza E. Unresolved issues in the epidemiology and diagnosis of bacteremia: an opinion paper. Rev Esp Quimioter 2022;35:519-37. .
12. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39:309-17. .
13. Verway M, Brown KA, Marchand-Austin A, Diong C, Lee S, Langford B, et al. Prevalence and mortality associated with bloodstream organisms: a population-wide retrospective cohort study. J Clin Microbiol 2022;60:e0242921. .
14. Diekema DJ, Hsueh PR, Mendes RE, Pfaller MA, Rolston KV, Sader HS, et al. The microbiology of bloodstream infection: 20-year trends from the SENTRY antimicrobial surveillance program. Antimicrob Agents Chemother 2019;63:e00355-19. .
15. Kim D, Yoon EJ, Hong JS, Choi MH, Kim HS, Kim YR, et al. Major bloodstream infectioncausing bacterial pathogens and their antimicrobial resistance in South Korea, 2017–2019: Phase I report from Kor-GLASS. Front Microbiol 2022;12:799084. .
16. Huh K, Kim J, Cho SY, Ha YE, Joo EJ, Kang CI, et al. Continuous increase of the antimicrobial resistance among gram-negative pathogens causing bacteremia: a nationwide surveillance study by the Korean Network for Study on Infectious Diseases (KONSID). Diagn Microbiol Infect Dis 2013;76:477-82. .
17. Elzi L, Babouee B, Vögeli N, Laffer R, Dangel M, Frei R, et al. How to discriminate contamination from bloodstream infection due to coagulase-negative staphylococci: a prospective study with 654 patients. Clin Microbiol Infect 2012;18:E355-61. .
18. Kim NH, Hwang JH, Song KH, Choe PG, Park WB, Kim ES, et al. Changes in antimicrobial susceptibility of blood isolates in a university hospital in South Korea, 1998-2010. Infect Chemother 2012;44:275-81. .
19. Inagaki K, Lucar J, Blackshear C, Hobbs CV. Methicillin-susceptible and methicillin-resistant Staphylococcus aureus bacteremia: nationwide estimates of 30-day readmission, in-hospital mortality, length of stay, and cost in the United States. Clin Infect Dis 2019;69:2112-8. .
20. Oh TS, Nam YS, Kim YJ, Yang H, Lee M, Gu HJ, et al. Trends in bloodstream infections at a Korean university hospital between 2008 and 2013. Ann Clin Microbiol 2015;18:14-9. .
21. Kim SY, Lim G, Kim MJ, Suh JT, Lee HJ. Trends in five-year blood cultures of patients at a university hospital (2003~2007). Korean J Clin Microbiol 2009;12:163-8.61:e01086-22. .
22. Clinical and Laboratory Standard Institute. Performance standards for antimicrobial susceptibility testing. CLSI M100. 29th ed. Wayne, PA; CLSI: 2019. .
23. One Health AMR. Kor-GLASS. https://www.kdca.go.kr/nohas/common/main.do [Online] (last visited on 17 November 2023). .
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