Evidence map›Paper›PMID 35590391›Full record

ArticleAntimicrobial resistance and infection control2022

Blood culture utilization and epidemiology of antimicrobial-resistant bloodstream infections before and during the COVID-19 pandemic in the Indonesian national referral hospital.

Robert Sinto, Khie Chen Lie, Siti Setiati, Suhendro Suwarto, Erni J Nelwan, Dean Handimulya Djumaryo, Mulya Rahma Karyanti, Ari Prayitno, Sumariyono Sumariyono, Catrin E Moore and 3 more

Open access · goldAbstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 4 countries.

Robert SintoDivision of Tropical and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National Hospital - Faculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10430, Indonesia. robert.sinto01@ui.ac.id.ORCID 0000-0003-3857-300X
Khie Chen LieDivision of Tropical and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National Hospital - Faculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10430, Indonesia.ORCID 0000-0002-9572-5260
Siti SetiatiFaculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10440, Indonesia.
Suhendro SuwartoDivision of Tropical and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National Hospital - Faculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10430, Indonesia.
Erni J NelwanDivision of Tropical and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National Hospital - Faculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10430, Indonesia.
Dean Handimulya DjumaryoFaculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10440, Indonesia.
Mulya Rahma KaryantiFaculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10440, Indonesia.
Ari PrayitnoFaculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10440, Indonesia.
Sumariyono SumariyonoFaculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10440, Indonesia.
Catrin E MooreCentre for Neonatal and Paediatric Infection, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
Raph L HamersFaculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10440, Indonesia.
Nicholas P J DayNuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LG, UK.
Direk LimmathurotsakulNuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LG, UK.
University of Indonesia · IDMahidol University · THAngkor Hospital for Children · KHEijkman Institute for Molecular Biology · IDSt George's, University of London · GB

Funding

Wellcome TrustWellcome Trust 220211
6 · The paper itself

Abstract

backgroundThere is a paucity of data regarding blood culture utilization and antimicrobial-resistant (AMR) infections in low and middle-income countries (LMICs). In addition, there has been a concern for increasing AMR infections among COVID-19 cases in LMICs. Here, we investigated epidemiology of AMR bloodstream infections (BSI) before and during the COVID-19 pandemic in the Indonesian national referral hospital.

methodsWe evaluated blood culture utilization rate, and proportion and incidence rate of AMR-BSI caused by WHO-defined priority bacteria using routine hospital databases from 2019 to 2020. A patient was classified as a COVID-19 case if their SARS-CoV-2 RT-PCR result was positive. The proportion of resistance was defined as the ratio of the number of patients having a positive blood culture for a WHO global priority resistant pathogen per the total number of patients having a positive blood culture for the given pathogen. Poisson regression models were used to assess changes in rate over time.

resultsOf 60,228 in-hospital patients, 8,175 had at least one blood culture taken (total 17,819 blood cultures), giving a blood culture utilization rate of 30.6 per 1,000 patient-days. A total of 1,311 patients were COVID-19 cases. Blood culture utilization rate had been increasing before and during the COVID-19 pandemic (both p < 0.001), and was higher among COVID-19 cases than non-COVID-19 cases (43.5 vs. 30.2 per 1,000 patient-days, p < 0.001). The most common pathogens identified were K. pneumoniae (23.3%), Acinetobacter spp. (13.9%) and E. coli (13.1%). The proportion of resistance for each bacterial pathogen was similar between COVID-19 and non-COVID-19 cases (all p > 0.10). Incidence rate of hospital-origin AMR-BSI increased from 130.1 cases per 100,000 patient-days in 2019 to 165.5 in 2020 (incidence rate ratio 1.016 per month, 95%CI:1.016-1.017, p < 0.001), and was not associated with COVID-19 (p = 0.96).

conclusionsIn our setting, AMR-BSI incidence and etiology were similar between COVID-19 and non-COVID-19 cases. Incidence rates of hospital-origin AMR-BSI increased in 2020, which was likely due to increased blood culture utilization. We recommend increasing blood culture utilization and generating AMR surveillance reports in LMICs to inform local health care providers and policy makers.

Indexed as

COVID-19Cross InfectionSepsisAnti-Bacterial AgentsBacteriaBlood CultureEscherichia coliHospitalsHumansIndonesiaKlebsiella pneumoniaePandemicsReferral and ConsultationSARS-CoV-2Anti-Bacterial AgentsAntimicrobial resistanceBlood cultureBlood culture utilizationBloodstream infectionCOVID-19Indonesia

Identifiers

PMID35590391
PMCPMC9117993
OpenAlexW4280561854

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.