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

Staphylococcus aureus bacteremia is associated with high mortality and morbidity, requiring prompt and appropriate antimicrobial treatment. Therefore, it is important to detect methicillin-resistant S. aureus (MRSA) rapidly from blood cultures. Two immunochromatographic tests, BinaxNow S. aureus and BinaxNow PBP2a, were directly applied to 79 Bact/Alert bottles that were positive for Gram positive cocci in cluster aggregations. Sensitivity and specificity for the identification of S. aureus and determination of methicillin resistance were 94% and 87%, and 100% and 100%, respectively, with less than 30 min of performance time. These tests are efficient and rapid; these tests are valuable alternatives to more sophisticated and expensive methods used in the diagnosis of MRSA bacteremia.
Bacteremia ; Diagnosis ; Gram-Positive Cocci ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Staphylococcus aureus*

Use of central venous catheters (CVCs) can lead to catheter-related bloodstream infections (CRBSIs) and such infections are associated with serious morbidity and mortality and with increased health care costs. The diagnosis of CRBSI needs to be accurate for adequate management. Semiquantitative catheter tip culture has been established as standard in most laboratories, but this method requires catheter removal. Catheter-sparing diagnostic methods, such as differential quantitative blood cultures and differential time to positivity have emerged as reliable diagnostic techniques. Management of CRBSIs involves deciding on catheter removal and the type and duration of systemic antimicrobial therapy. Such decisions depend on the identity of the organism causing the bloodstream infection and the clinical and radiographic manifestations suggesting a complicated course.
Bacteremia ; Catheter-Related Infections* ; Catheters ; Central Venous Catheters ; Diagnosis* ; Health Care Costs ; Methods ; Mortality

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