KOSIN UNIVERSITY COLLEGE OF MEDICINE
Articles
- Page Path
- HOME > Kosin Med J > Volume 33(1); 2018 > Article
-
Original Article
Changes in Antimicrobial Susceptibility Pattern of Blood Isolates at a University Hospital in the Kyungnam area during 2005-2014 - Dahae Yang, Woonhyoung Lee
-
Kosin Medical Journal 2018;33(1):29-40.
DOI: https://doi.org/10.7180/kmj.2018.33.1.29
Published online: January 21, 2018
Department of Laboratory Medicine, College of Medicine, Kosin University Busan, Korea
- Corresponding Author: Woonhyoung Lee, Department of Laboratory Medicine, College of Medicine, Kosin University, 262, Gamchen-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-6373 Fax: +82-51-990-3034 E-mail: lukerubicon@gmail.com
• Received: January 12, 2017 • Accepted: March 15, 2017
Copyright © 2018 Kosin University School of Medicine Proceedings
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
- 1,315 Views
- 1 Download
Abstract
-
Objectives
- Blood culture is a one of the most important procedure for diagnosis and treatment of infectious disease, but distribution of pathogenic species and the antimicrobial susceptibility can be vary from pathogen, individual trait, regional or environmental features. In this study, we investigated the changes in frequency of occurrence and antimicrobial susceptibility pattern of blood isolates from 2005 to 2014.
-
Methods
- Data of blood isolates from Kosin Gospel Hospital during 2005 to 2014 were analyzed retrospectively. Blood isolates were cultured for 5 days using BACTEC Plus Aerobic/F and BACTEC lytic/10 Anaerobic/F. Identification and antimicrobial susceptibility test was performed using VITEK 1 system, VITEK 2 XL, PHOENIX 100 and conventional method.
-
Results
- 9,847 isolates were identified during 10 years. Among the isolates aerobic or falcutative anaerobic bacteria were isolated in 99.5% specimens, anaerobic were 0.1%, and fugi were 0.4%. Most commonly isolated bacteria were coagulase-negative Staphylococcus (CoNS) followed by Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Candida parapsilosis were most frequently isolated among fungi. The proportion of S. aureus, A. baumannii and E. faecium were increased, while Pseudomonas aeruginosa and Streptococcus pneumoniae decreased over decennium. Imipenem resistant K. pneumoniae were identified. Vancomycin resistant E. faecium and imipenem resistant A. baumannii were increased (7.1% in 2005 to 12.3% in 2014, 0% in 2005 to 55.6% in 2014, respectively).
-
Conclusions
- Over the last 10 year, CoNS were the most frequently isolated pathogen. Imipenem resistant K. pneumoniae was emerged. Vancomycin resistant E. faecium and imipenem resistant A. baumannii increased during this period.
Fig. 2.Trends in antimicrobial resistance (%) of (A) S. aureus, (B) E. faecalis, (C) E. faecium, (D) E. coli (E) K. pneumonia (F) P. aeruginosa and (G) A. baumannii by year.
Table 1.Microorganisms isolated by year
Table 2.Distribution of blood isolates
- 1.Washington JA 2nd. Blood cultures: principles and techniques. Mayo Clin Proc 1975;50:91–8.PubMed
- 2.Weinstein MP, Reller LB, Murphy JR, Lichtenstein KA. The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. I. Laboratory and epidemiologic observations. Rev Infect Dis 1983;5:35–53.ArticlePubMed
- 3.Arias CA, Murray BE. Antibiotic-resistant bugs in the 21st century--a clinical super-challenge. N Engl J Med 2009;360:439–43.ArticlePubMed
- 4.Kang CI, Song JH. Antimicrobial resistance in Asia: current epidemiology and clinical implications. Infect Chemother 2013;45:22–31.ArticlePubMedPMC
- 5.World Health Organization. Antimicrobial resistance: global report on surveillance. 2014.
- 6.Bronzwaer S, Lönnroth A, Haigh R. The European Community strategy against antimicrobial resistance. Euro Surveill 2004;9:30–4.ArticlePubMed
- 7.Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MAManual of clinical microbiology. 9th ed.Washington, DC: American Society for Microbiology Press; 2007.
- 8.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.Article
- 9.Beekmann SE, Diekema DJ, Doern GV. Determining the clinical significance of coagulase-negative staphylococci isolated from blood cultures. Infect Control Hosp Epidemiol 2005;26:559–66.ArticlePubMed
- 10.Tokars JI. Predictive value of blood cultures positive for coagulase-negative staphylococci: implications for patient care and health care quality assurance. Clin Infect Dis 2004;39:333–41.ArticlePubMed
- 11.Kim HJ, Lee NY, Kim S, Shin JH, Kim MN, Kim EC, et al. Characteristics of Microorganisms Isolated from Blood Cultures at Nine University Hospitals in Korea during 2009. Korean J Clin Microbiol 2011;14:48–54.Article
- 12.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.Article
- 13.Koh EM, Lee SG, Kim CK, Kim M, Yong D, Lee K, et al. Microorganisms isolated from blood cultures and their antimicrobial susceptibility patterns at a university hospital during 1994-2003. Korean J Lab Med 2007;27:265–75.ArticlePubMed
- 14.Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006;19:788–802.ArticlePubMedPMC
- 15.Yang YL, Hsieh LY, Wang AH, Lo HJ. TSARY Hospitals. Characterization of Candida Species from Different Populations in Taiwan. Mycopathologia 2011;172:131–9.ArticlePubMed
- 16.Yapar N. Epidemiology and risk factors for invasive candidiasis. Ther Clin Risk Manag 2014;10:95–105.ArticlePubMedPMC
- 17.Trofa D, Gácser A, Nosanchuk JD. Candida parapsilosis, an emerging fungal pathogen. Clin Microbiol Rev 2008;21:606–25.ArticlePubMedPMCPDF
- 18.Kim YC, Kim MH, Song JE, Ahn JY, Oh DH, Kweon OM, et al. Trend of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in an institution with a high rate of MRSA after the reinforcement of antibiotic stewardship and hand hygiene. Am J Infect Control 2013;41:e39–43.ArticlePubMed
- 19.Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clin Infect Dis 2011;53:60–7.ArticlePubMed
- 20.Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA, et al. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 2008;29:996–1011.ArticlePubMed
- 21.Sanchez GV, Master RN, Clark RB, Fyyaz M, Duvvuri P, Ekta G, et al. Klebsiella pneumoniae antimicrobial drug resistance, United States, 1998-2010. Emerg Infect Dis 2013;19:133–6.ArticlePubMedPMC
- 22.Schwaber MJ, Carmeli Y. Mortality and delay in effective therapy associated with extended-spectrum beta-lactamase production in Enterobacteriaceae bacteraemia: a systematic review and meta-analysis. J Antimicrob Chemother 2007;60:913–20.PubMed
- 23.Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis 2006;42:692–9.ArticlePubMed
- 24.Dijkshoorn L, Nemec A, Seifert H. An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol 2007;5:939–51.ArticlePubMed
References
Figure & Data
References
Citations
Citations to this article as recorded by 
PubReader
Cite
XML DownloadChanges in Antimicrobial Susceptibility Pattern of Blood Isolates at a University Hospital in the Kyungnam area during 2005-2014
Fig. 1. Annual isolation of relatively common species of bacteria during 2005-2014
Fig. 2. Trends in antimicrobial resistance (%) of (A) S. aureus, (B) E. faecalis, (C) E. faecium, (D) E. coli (E) K. pneumonia (F) P. aeruginosa and (G) A. baumannii by year.
Fig. 1.
Fig. 2.
Changes in Antimicrobial Susceptibility Pattern of Blood Isolates at a University Hospital in the Kyungnam area during 2005-2014
Microorganisms isolated by year
| Oreauisin | No. of isolate according to years | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | Tola] (%) | ||
| Gram-positive Cocci | 239 | 349 | 372 | 566 | 584 | 748 | 699 | 674 | 614 | 563 | 5408 | (54.9) |
| Gram-negativ cocci | 1 | 0 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 5 | (0.1) |
| Garm-positive bacilli | 7 | 22 | 24 | 2 | 1 | 4 | 2 | 8 | 3 | 3 | 76 | (0.8) |
| Gram-negativ bacilli | 269 | 284 | 325 | 386 | 409 | 436 | 518 | 526 | 563 | 587 | 4303 | (43.7) |
| Abaerobic | 0 | 0 | 0 | 0 | 0 | 1 | 3 | 3 | 3 | 1 | 11 | (0.1) |
| Fungi | 0 | 1 | 4 | 5 | 5 | 8 | 8 | 6 | 6 | 4 | 44 | (0.4) |
| Tolal | 516 | 656 | 726 | 960 | 1000 | 1197 | 1227 | 1217 | 1190 | 1158 | 9847 | (100.0) |
Distribution of blood isolates
| Organisms | No. ofisolates | % |
|---|---|---|
| Gram positive organisms | ||
| Staphylococcus, coagulase-negative | 2761 | 28.0 |
| Staphylococcus aureus | 1074 | 10.9 |
| α- hemolytic Staphylococcus | 502 | 5.1 |
| Entero coccus faecium | 392 | 4.0 |
| Enterococcus faecalis | 238 | 2.4 |
| Streptococcus pneumoniae | 136 | 1.4 |
| Bacillus spp. | 4.5 | 0.5 |
| Corym bacterium spp. | 29 | 0.3 |
| Other gram positive | 307 | 3.1 |
| Gram negative organisms | ||
| Escherichia coli | 2078 | 21.1 |
| Klebsiella pneumoniae | 857 | 3.7 |
| Enterobacter spp. | 273 | 2.3 |
| Acinetobacter baumannii | 225 | 2.3 |
| Pseudomonas aeruginosa | 211 | 2.1 |
| Serratia spp. | 74 | 0.3 |
| Aemmonas spp. | 73 | 0.7 |
| Stenotrqphomonas maltophilia | 72 | 0.7 |
| Other gram negative | 445 | 4.5 |
| Anaerobic organi ans | ||
| Lactococcus garvieae | 1 | <0.1 |
| Propionibacterium acnes | 8 | 0.1 |
| Bacteroides fragilis | 1 | <0.1 |
| Chromo bacterium violaceum | 1 | <0.1 |
| Fungal organisms | ||
| Candida albicans | 8 | 0.1 |
| Candida tropicalis | 3 | <0.1 |
| Candida glabrata | 8 | 0.1 |
| Candidaparaps “dosis | 17 | 0.2 |
| Other Yeast | 8 | 0.1 |
| Total | 9847 | 100.0 |
Table 1. Microorganisms isolated by year
Table 2. Distribution of blood isolates
