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

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

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*

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