Koh Eun Mi, Lee Sang Guk, Kim Chang Ki, Kim Myungsook, Yong Dongeun, Lee Kyungwon, Kim June Myung, Kim Dong Soo, Chong Yunsop
Department of Laboratory Medicine, Yonsei University Colleage of Medicine, Seoul, Korea.
Korean J Lab Med. 2007 Aug;27(4):265-75. doi: 10.3343/kjlm.2007.27.4.265.
Blood culture is important for the determination of the etiologic agent of bacteremia. Analysis of blood culture results and antimicrobial susceptibility trend can provide clinicians with relevant information for the empirical treatment of patients.
The species and antimicrobial susceptibility of the isolates from blood cultures at the Severance Hospital during 1994-2003 were analysed. Blood specimens were cultured for 7 days using tryptic soy broth and thioglycollate medium. Identification of organism was based on conventional methods or commercial kit systems. Antimicrobial susceptibility was tested by a disk diffusion method.
Of 536,916 blood specimens cultured, 24,877 (4.6%) from 13,102 patients were positive. Among the isolates, 93.1% were aerobic or facultative anaerobic bacteria, 3.3% anaerobes, and 3.6% fungi. Escherichia coli was isolated most frequently, followed by Staphylococcus aureus, alpha-hemolytic Streptococcus, Enterococcus spp., and Klebsiella pneumoniae. The proportion of patients with Enterococcus faecium and K. pneumoniae gradually increased during this study. Enterococcus, S. aureus and alpha-hemolytic Streptococcus were frequently isolated from the age group of less than 2 yr. E. coli, Enterococcus spp., K. pneumoniae and S. aureus from the age group of over 50 yr. Oxacillin-resistant S. aureus decreased, whereas vancomycin-resistant E. faecium and imipenemresistant Pseudomonas aeruginosa and Acinetobacter baumannii increased.
E. coli was the most common cause of bacteremia and S. aureus, alpha-hemolytic Streptococcus, and K. pneumoniae were frequently isolated pathogens. The bacteremia due to Enterococcus, K. pneumoniae, fungi, vancomycin-resistant E. faecium, and imipenem-resistant P. aeruginosa and A. baumannii gradually increased during this period.
血培养对于确定菌血症的病原体至关重要。分析血培养结果和抗菌药物敏感性趋势可为临床医生对患者进行经验性治疗提供相关信息。
对1994年至2003年期间首尔延世大学Severance医院血培养分离株的菌种及抗菌药物敏感性进行分析。血标本采用胰蛋白胨大豆肉汤和硫乙醇酸盐培养基培养7天。采用常规方法或商业试剂盒系统鉴定细菌。采用纸片扩散法检测抗菌药物敏感性。
在536,916份培养的血标本中，来自13,102例患者的24,877份（4.6%）呈阳性。在分离株中，93.1%为需氧菌或兼性厌氧菌，3.3%为厌氧菌，3.6%为真菌。大肠埃希菌分离频率最高，其次为金黄色葡萄球菌、α溶血性链球菌、肠球菌属和肺炎克雷伯菌。在本研究期间，粪肠球菌和肺炎克雷伯菌感染患者的比例逐渐增加。肠球菌、金黄色葡萄球菌和α溶血性链球菌常见于2岁以下年龄组。大肠埃希菌、肠球菌属、肺炎克雷伯菌和金黄色葡萄球菌常见于50岁以上年龄组。耐苯唑西林金黄色葡萄球菌减少，而耐万古霉素粪肠球菌、耐亚胺培南铜绿假单胞菌和鲍曼不动杆菌增加。
大肠埃希菌是菌血症最常见的病因，金黄色葡萄球菌、α溶血性链球菌和肺炎克雷伯菌是常见的分离病原体。在此期间，肠球菌、肺炎克雷伯菌、真菌、耐万古霉素粪肠球菌以及耐亚胺培南铜绿假单胞菌和鲍曼不动杆菌所致菌血症逐渐增加。
