Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology
Volume 24 │ Issue 1 │ March 2021
Original article

Educational Intervention to Improve Blood Culture Indicators in a Secondary-Care Hospital

Seungjun Lee, Seong Chun Kim, Sunjoo Kim

Ann Clin Microbiol 2021 March, 24(1): 1-9. Published on 20 March 2021.

Background: Blood culture is essential for diagnosis of sepsis. However, usually the available blood volume is not sufficient to meet the guidelines. Thus, periodic monitoring and feedback are essential to improve the quality of blood cultures.

Methods: We analyzed blood cultures requested between November 2018 and June 2019, and provided educational intervention and coaching for phlebotomists at the end of February 2019. Then, we evaluated the impact of education on blood cultures in a secondary‑care hospital. Blood volume, positive rate, contamination rate, and time to detection (TTD) were compared between the pre‑ (November 2018 to February, 2019) and post‑intervention periods (March to June, 2019).

Results: The average blood volume increased significantly from 5.4 mL to 7.1 mL (P < 0.0001) (35.2%) after intervention. Accordingly, the proportion of optimal blood volume (8–12 mL) increased from 9.1% to 37.8% (P < 0.0001). Before the intervention, the positivity rate was 9.6% and the contamination rate was 0.5%, whereas after the intervention, the positivity rate decreased to 9.1% and the contamination rate increased to 1.1%. TTD improved from 14.7 hours to 13.1 hours (P = 0.0420).

Conclusion: The educational intervention of the phlebotomy team improved the quality of blood cultures, especially blood volumes and TTD. However, the positivity rate did not increase, suggesting that it is affected not only by the blood volumes but also by the severity of the underlying illnesses of the patient in a secondary‑care hospital.

[in Korean]

Original article

Risk Factors Associated with Recurrent Urinary Tract Infection Caused by Escherichia coli

Young Ah Kim, Ea Wha Kang, Young Hee Seo, Kyungwon Lee

Ann Clin Microbiol 2021 March, 24(1): 11-20. Published on 20 March 2021.

Background: The purpose of this study was to analyze the clinical and microbiological characteristics of recurrent urinary tract infection (UTI) caused by Escherichia coli— the most common etiological agent.

Methods: Cases of recurrent and single episodes of UTI caused by E. coli were evaluated retrospectively for a period of 6 months (January-June 2019) to analyze the clinical and molecular characteristics of this disease.

Results: Healthcare-associated UTI, E. coli bacteremia, and poor microbial clearance 7 days post infection were associated more with the recurrent episodes of infection. E. coli isolates from subjects with recurrent UTIs showed higher rates of antimicrobial resistance and extended-spectrum β-lactamase (ESBL) production. The E. coli clone— sequence type 131 was detected in similar proportions in isolates, recovered from subjects in both groups— recurrent episodes and single episode of UTI.

Conclusion: The control of antimicrobial-resistant ESBL-producing E. coli strains may be difficult using antimicrobial therapy and subsequently delay the clearance of the etiologic agent. This could play a major role in the development of recurrent UTIs.

Original article

Comparative Evaluation of the STANDARD F Influenza A/B FIA Test with the Sofia Influenza A+B FIA and SD BIOLINE Influenza Ag A/B/A(H1N1) tests for Influenza A Virus Detection

Soohun Yoo, Si Hyun Kim, Ga Won Jeon, Yo-Han Park, Sae Am Song, Jeong Hwan Shin

Ann Clin Microbiol 2021 March, 24(1): 21-26. Published on 20 March 2021.

Background: This study aimed to evaluate the diagnostic performance of the STANDARD F Influenza A/B FIA test (SD Biosensor Inc., Korea) for the rapid detection of influenza A virus in comparison with the Sofia Influenza A+B FIA (Quidel Corp., USA) and SD BIOLINE Influenza Ag A/B/A(H1N1) (Standard Diagnostic, Inc., Korea) tests.

Methods: A total of 227 non-duplicated nasopharyngeal aspirates submitted for real-time RT-PCR analysis were included in the study. We used the three commercial tests in remnant samples from routine assays, according to the manufacturer’s instructions. We analyzed the diagnostic performance, including sensitivity and specificity, of the three tests.

Results: Real-time RT-PCR analysis showed that 67 (29.5%) samples were positive and 160 (70.5%) were negative for influenza A virus, and that all the specimens were negative for influenza B. The overall sensitivity and specificity for influenza A virus detection were 50.7% and 100% for the STANDARD F, 50.7% and 100% for the Sofia, and 29.9% and 100% for the SD BIOLINE tests, respectively. The STANDARD F and SD BIOLINE tests showed negative results for influenza B virus in all specimens, whereas the Sofia test showed two false-positive results.

Conclusion: The STANDARD F Influenza A/B test showed a good diagnostic performance and may be useful for the rapid diagnosis of influenza A.

Letter

The Impact of Social Distancing on the Transmission of Acute Respiratory Viruses during the COVID-19 Pandemic

Kuenyoul Park, Heungsup Sung, Mi-Na Kim

Ann Clin Microbiol 2021 March, 24(1): 27-29. Published on 20 March 2021.

To the Editor, Since the first confirmed case of coronavirus disease 2019 (COVID-19) on January 20, 2020, the Korean government reported a total of 8,799 COVID-19 patients until March 21, 2020, which were mainly attributed to community outbreaks. This novel respiratory viral infection is so feared that the number of individuals using public transport has dropped dramatically. Moreover, enhanced social distancing measures, including refraining from going out and following personal hygiene practices such as hand washing and wearing a mask, were announced on March 21. These strategies successfully attenuated COVID-19 transmission in South Korea.

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