Trends in bacterial and fungal bloodstream infections in Southeast Asia: A review of blood culture pathogens (2018-2024).

Abstract

Bloodstream infections (BSIs) pose a significant health burden in clinical settings, contributing to high morbidity and mortality rates worldwide. This review aims to analyze the trends of bacterial and fungal BSI and blood culture pathogen profiles reported in adolescents and adults in Southeast Asian (SEA) countries, drawing from published studies between 2018 and 2024. A comprehensive literature search was conducted via PubMed, Scopus, Web of Science, and Cochrane Library, analyzing 23 studies that included 14,512 patients from 7 SEA countries. The narrative review highlighted various prevalence rates of bacterial and fungal BSIs among different patient groups: those with indwelling catheters (0.6%-46.9%), sepsis (12.6%-44.5%), and hospitalized patients with other comorbidities (1.1%-29.5%). Blood culture findings revealed that Escherichia coli and Staphylococcus aureus were the most commonly isolated gram-negative and gram-positive bacteria, respectively, while Candida species emerged as the predominant fungal pathogen. Notably, non-albicans Candida species were more common than Candida albicans in SEA fungemia patients. The overall findings of pathogen distribution in blood cultures from SEA patients are consistent with global surveillance data; however, distinct regional pathogens endemic to SEA, particularly Burkholderia pseudomallei and Talaromyces marneffei, were also identified. Significant gaps exist in determining bacterial and fungal BSI epidemiology among vulnerable populations, including the acquisition sources, risk factors, antimicrobial resistance patterns, and mortality rates across the SEA region. Overcoming challenges arising from inadequate surveillance and diagnostic capabilities could significantly reduce the BSI burden in the region.

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