BACKGROUND: Blood culture for diagnosis of bacteremia and fungemia comprises aerobic and anaerobic cultures. The clinical utility of routine anaerobic blood culture has been questioned for a long time and was evaluated in this study. METHODS: A total of 9,028 positive blood cultures were collected from adults at four university-affiliated hospitals. We recorded the species distribution according to growth in aerobic or anaerobic culture. RESULTS: Among the 9,028 positive results, 3,239 cases (35.9%) occurred in aerobic culture, 1,543 cases (17.1%) in anaerobic culture and 4,246 cases (47.0%) in both cultures. The species grown only in the anaerobic cultures consisted of 81.4% facultative anaerobes, 2.0% strict anaerobes, 8.5% strict aerobes, and 8.1% yeasts. CONCLUSION: Routine use of paired aerobic/anaerobic blood culture is essential because a considerable number of facultative anaerobes and yeasts grow only in anaerobic blood culture. Strict aerobes and fungi were more commonly isolated in the anaerobic bottles than were strict anaerobes.
Adult ; Bacteremia ; Diagnosis ; Fungemia ; Fungi ; Humans ; Yeasts

BACKGROUND: Early recognition of fungemia is essential for successful treatment. However, methods to culture fungus specimen taken from fungemia patients are difficult and time consuming. To assess the clincal usefulness of beta-D-glucan in the detection of fungemia, we compared serum (1-->3)-beta-D-glucan concentrations in fungemia, bacteremia, and healthy persons. METHODS: From August 2001 to October 2002, serum (1-->3)-beta-D-glucan concentrations were measured by turbidometric assay in 16 fungemia patients, 13 bacteremia patients and 18 healthy persons. Differences in (1-->3)-beta-D-glucan concentrations between fungemia patients and other groups were compared by t-test. RESULTS: Fungemia patients were composed of 10 male and 6 female patients, and mean age was 52.9+/-16.2 years. The cut-off value for a positive result was 11 pg/mL. thirteen out of 16 fungemia patients had concentrations above the cul-off value (range:11.5-863 pg/mL, sensitivity:81.3%, specificity:100%), and mean concentration in fungemia was 217.8+/-273.8 pg/mL. Mean concentration in bacteremia was 0.1+/-0.3 pg/mL, and all the patients with bacteremia had the concentrations below the cut-off value. Mean concentration in the healthy persons was 0 pg/mL and all healthy persons had concentration below the cut-off value. The concentration in fungemia was statistically significantly higher than those of the other two groups(p-value: respectively 0.006, 0.006) CONCLUSION: We concluded that serum (1-->3)-beta-D-glucan is useful for the diagnosis of fungemia. Further study on the usefullness of serum (1->3)-beta-D-glucan for early detection of fungemia and therapeutic monitoring is warranted.
Bacteremia ; Diagnosis* ; Female ; Fungemia* ; Fungi ; Humans ; Male

BACKGROUND: Early recognition of fungemia is essential for successful treatment. However, methods to culture fungus specimen taken from fungemia patients are difficult and time consuming. To assess the clincal usefulness of beta-D-glucan in the detection of fungemia, we compared serum (1-->3)-beta-D-glucan concentrations in fungemia, bacteremia, and healthy persons. METHODS: From August 2001 to October 2002, serum (1-->3)-beta-D-glucan concentrations were measured by turbidometric assay in 16 fungemia patients, 13 bacteremia patients and 18 healthy persons. Differences in (1-->3)-beta-D-glucan concentrations between fungemia patients and other groups were compared by t-test. RESULTS: Fungemia patients were composed of 10 male and 6 female patients, and mean age was 52.9+/-16.2 years. The cut-off value for a positive result was 11 pg/mL. thirteen out of 16 fungemia patients had concentrations above the cul-off value (range:11.5-863 pg/mL, sensitivity:81.3%, specificity:100%), and mean concentration in fungemia was 217.8+/-273.8 pg/mL. Mean concentration in bacteremia was 0.1+/-0.3 pg/mL, and all the patients with bacteremia had the concentrations below the cut-off value. Mean concentration in the healthy persons was 0 pg/mL and all healthy persons had concentration below the cut-off value. The concentration in fungemia was statistically significantly higher than those of the other two groups(p-value: respectively 0.006, 0.006) CONCLUSION: We concluded that serum (1-->3)-beta-D-glucan is useful for the diagnosis of fungemia. Further study on the usefullness of serum (1->3)-beta-D-glucan for early detection of fungemia and therapeutic monitoring is warranted.
Bacteremia ; Diagnosis* ; Female ; Fungemia* ; Fungi ; Humans ; Male

Bacteremia ; diagnosis ; Humans ; Infant, Newborn ; Male ; Pseudomonas Infections ; diagnosis

Bacteremia ; diagnosis ; Endoscopy ; adverse effects ; Humans ; Paranasal Sinuses ; microbiology ; surgery

Bacteremia ; diagnosis ; Glomerulonephritis ; diagnosis ; Humans ; Lymphadenitis ; diagnosis ; Male ; Pneumococcal Infections ; diagnosis

Bacteremia ; diagnosis ; drug therapy ; Child ; Female ; Humans ; Mannheimia haemolytica ; Pasteurellaceae Infections ; diagnosis ; drug therapy

BACKGROUND: Blood culture has been used for finding the etiology of bacteremia. The results of its susceptibility test can be an important tool for deciding the direction of treatment. However, the rate of positive blood culture is very low; it, most of all, is because of the abuse of antimicrobials. Especially under the condition which allows anyone to get antimicrobials at any pharmacies and hospitals without antimicrobial susceptibility test as in Korea, the abuse of antimicrobials be brought about, but there is no concrete information about it. METHODS: The rate of antimicrobial abuse and the serum antimicrobial activities of 106 patients, whose blood was requested for diagnosis of bacteremia, were investigated, and the results were compared with blood culture results. Thirteen mililiters of blood was as eptically extracted; 10 ml out of it was used for blood culture and the serum separated from 3ml of blood was used for serum antibacterial activities. For the test of serum antimicrobial activities, standard strain of bacteria, Staphylococcus aureus ATCC 25923, which are susceptible to every antibiotics was used. And for the blood culture, blood samples were inoculated to aerobic and anaerobic culture broth, and incubated in the automated blood culture system. The abuse of antimicrobials were investigated by the interview with patients and the medical records at admission. RESULTS: The antimicrobial abuse rate was 78.3%(83/106), and the rate of positive blood culture was as low as 6.6%(7/106). The rate of positive serum antibacterial activity was 47.2%(50/106). The rate of positive blood culture in the group of positive serum antimicrobial activity was only 4%(2/50) and that in the group of negative serum antimicrobial activity was 8.9%(5/56). And in the group of positive blood culture, the rate of positive serum antimicrobial activity was 28.6%(2/7) and the rate of negative activity was 71.4%(5/7). CONCLUSIONS: The antimicrobial abuse rate in Korea was considerably high, and the rate of positive blood culture was very low. The rate of positive blood culture in the group of positive serum antibacterial activity was conspicuously lower than that in the group of negative ones. According to these results, the use of antimicrobials before blood culture should be carefully considered for the diagnosis and treatment of bacterial infection.
Anti-Bacterial Agents ; Bacteremia ; Bacteria ; Bacterial Infections ; Diagnosis ; Humans ; Korea ; Medical Records ; Pharmacies ; Staphylococcus aureus

BACKGROUND: Rapidly growing mycobacteria (RGM) are ubiquitous in the environment such as water and soil. Recently, infections by RGM are described in increasing frequency, but isolation from blood cultures has been rarely reported in Korea. The aim of this study was to identify blood culture isolates by 16S rDNA sequencing and to determine their clinical significance. METHODS: Blood cultures were performed using an automated blood culture instrument (BacT/ Alert 3D, Organon Teknika, Durham, USA), and the isolates were identified by nucleotide sequencing for the 16S rDNA after PCR amplification. The clinical significance was determined by patient's symptoms, laboratory findings, radiologic findings, underlying diseases, clinical course, and response to therapy etc. RESULTS: RGM were isolated from 16 patients: the organisms were identified as Mycobacterium mucogenicum in 12 patients, and M. cosmeticum in 4 patients. Ten isolates were considered clinically significant and the remaining four as contaminants. CONCLUSIONS: RGM can be detected in routine blood cultures; therefore, they should not be confused with other gram-positive bacilli such as Corynebacteria, and the possibility of RGM in blood stream infections must be considered. It is necessary to identify RGM up to the species level for proper diagnosis and treatment. The clinical significance of RGM from blood cultures must be carefully assessed with the consideration of contamination.
Bacteremia ; Diagnosis ; DNA, Ribosomal ; Humans ; Korea ; Mycobacterium ; Polymerase Chain Reaction ; Rivers ; Soil

Flexible fiberoptic bronchoscopy is a useful tool for the diagnosis and management for diseases of the airway. Although it has been known to be a relatively safe procedure; in some cases, mild complications can occur after fiberoptlc bronchoscopy. However, fatal complications such as bacteremia, pneumonia, myocardial infarction, severe obstruction of the airways, respiratory failure or death have been reported. Among them, infectious complications following flexible fiberoptic bronchoscopy occur sometimes, although most of them are self-limited. We recently experienced a case of severe Klebsiella pneumoniae pneumonia in a patient presenting with fever following flexible fiberoptic bronchoscopy, We report this case to discuss the potential complications of fiberoptic bronchoscopy with a review of literature.
Bacteremia* ; Bronchoscopy* ; Diagnosis ; Fever ; Humans ; Klebsiella pneumoniae ; Klebsiella* ; Myocardial Infarction ; Pneumonia* ; Respiratory Insufficiency