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.
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.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Impact of COVID-19 pandemic on multidrug resistant gram positive and gram negative pathogens: A systematic review.Journal of infection and public health · 2023Pooled it
- Pooled it
- Aetiology and Antibiotic Susceptibility of Common Bacterial Infections in Hospitalised Patients: A 2019 Multisite Cross-Sectional Survey in Jakarta, Indonesia.Tropical medicine & international health : TM & IH · 2026Article
- The Influence of Seasonality and Antimicrobial Resistance Genes on Biofilm Formation in Hospital-Acquired Resistant Bacteria.Journal of epidemiology and global health · 2026Article
- Impact of switching from manual to automated aerobic blood culture on bacteremia diagnosis in Lao PDR.Microbiology spectrum · 2026Article
- Article
- Tools and challenges in the use of routine clinical data for antimicrobial resistance surveillance.npj antimicrobials and resistance · 2025Review
- Epidemiology of sepsis in hospitalised neonates in Indonesia: high burden of multidrug-resistant infections reveals poor coverage provided by recommended antibiotic regimens.BMJ global health · 2025Article
- Interrupted-time-series analysis of the impact of COVID-19 pandemic on blood culture utilization in Shanghai.BMC infectious diseases · 2025Article
- Impact of the COVID-19 pandemic on the consumption of antibiotics and the emergence of AMR: case study in a general hospital.Frontiers in public health · 2025Article
- Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022.The Journal of infection · 2024Article
- A scoping review of bacterial resistance among inpatients amidst the COVID-19 pandemic.Journal of global antimicrobial resistance · 2024Article
- Antimicrobial resistance among common bacterial pathogens in Indonesia: a systematic review.The Lancet regional health. Southeast Asia · 2024Article
- Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey.BMJ open · 2024Article
- Diagnostic and antibiotic use practices among COVID-19 and non-COVID-19 patients in the Indonesian National Referral Hospital.PloS one · 2024Article
- Article
- Effectiveness of multidisciplinary interventions to improve blood culture efficiency and optimize antimicrobial utilization.Frontiers in public health · 2024Article
- Evaluation of Blood Cultures from SARS-CoV-2-Positive and Negative Adult Patients.Healthcare (Basel, Switzerland) · 2023Article
- Local and timely antimicrobial resistance data for local and national actions: the early implementation of an automated tool for data analysis at local hospital level in Thailand.JAC-antimicrobial resistance · 2023Article
- The Hidden Cost of COVID-19: Focus on Antimicrobial Resistance in Bloodstream Infections.Microorganisms · 2023Review
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Authors and funding
13 authors at 5 institutions in 4 countries.
Funding
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.
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