Analysis of Blood Culture Data Influences Future Epidemiology of Bloodstream Infections: A 5-year Retrospective Study at a Tertiary Care Hospital in India

Sharma Anuradha; Arghadip Samaddar; Anand Maurya; Vivek Hada; Himanshu Narula; Twishi Shrimali; Neeraj Gupta; Prawin Kumar; Kuldeep Singh; Vijaya Lakshmi Nag

doi:10.5005/jp-journals-10071-23922

Analysis of Blood Culture Data Influences Future Epidemiology of Bloodstream Infections: A 5-year Retrospective Study at a Tertiary Care Hospital in India

Indian J Crit Care Med. 2021 Nov;25(11):1258-1262. doi: 10.5005/jp-journals-10071-23922.

Affiliations

¹ Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
² Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
³ Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Abstract

Background: Blood cultures are the most significant samples received in a microbiology laboratory. Good quality control of pre-analytic, analytic, and post-analytic stages can have a significant impact on patient outcomes. Here, we present the improvements brought about by reviewing blood culture data with clinicians at a tertiary care institute in India.

Methods: Four-year blood culture data (phase I-February 2014-February 2018) were shared with clinicians in the clinical grand round. Several take-home messages were discussed in a quiz format, and a number of holistic quality control measures were implemented at different levels. Based on observable changes in blood culture reports, another dataset was analyzed and compared in phase II (April 2018-April 2019).

Results: In phase II, the blood culture contamination rate improved from 6 to 2% along with four times reduction in ICU isolates and three times increased isolation of salmonellae and pneumococci. The development of resistance in Klebsiella pneumoniae to carbapenems and piperacillin-tazobactam was reduced. Colistin resistance in ICU isolates hovered around 15%. Vaccine-preventable pneumococcal serotypes were predominant in the under-five age-group. Typhoidal salmonellae were more commonly isolated from adults with 50% showing sensitivity to pefloxacin and 97% to ampicillin, chloramphenicol, and cotrimoxazole. Candida parapsilosis was the leading non-albicans Candida (NAC). Fluconazole resistance was observed in 50% of NAC.

Conclusion: Reviewing blood culture data with clinicians mutually helped us to improve the overall quality of blood culture reports. It had a major impact on epidemiological trends and thus, found to be superior to just sharing an antibiogram with the clinicians.

How to cite this article: Sharma A, Samaddar A, Maurya A, Hada V, Narula H, Shrimali T, et al. Analysis of Blood Culture Data Influences Future Epidemiology of Bloodstream Infections: A 5-year Retrospective Study at a Tertiary Care Hospital in India. Indian J Crit Care Med 2021;25(11):1258-1262.

Keywords: Blood culture; Bloodstream infections; Candida parapsilosis; Fluconazole resistance; Pneumococci; Salmonellae.