The China Academic Journal Full-text Database (CAJ) updated by
the China National Knowledge Infrastructure (CNKI) central servers
was searched for articles published between 2001 and 2009. CAJ is
currently the most comprehensive database of Chinese journals.14
The search terms utilized were ‘‘sepsis’’[MeSH] AND ‘‘blood
culture’’[MeSH]. The titles and abstracts of 420 citations were
initially identified, and irrelevant citations were excluded. Secondly,
the full texts were retrieved to identify eligible studies. Hospital-
based cross-sectional studies on blood culture examination for
patients with suspected sepsis in mainland China were eligible for the
analysis. The only exclusion criterion was an observation duration of
less than 1 year. Finally, 84 adult and 77 neonatal-pediatric patient
studies were included in the analysis. The positivity of a blood culture
examination was defined as the percentage of positive microorgan-
isms identified in the blood specimens from hospitalized patients
with suspected sepsis. Additionally, the proportions of Gram (+)
bacteria, Gram () bacteria, and fungus among all identified
microorganisms were extracted. The data on adult or neonatal-
pediatric patients were retrieved and extracted separately. The
eastern, central and western regions of China have different economic
conditions and healthcare accessibility.15 Therefore, the epidemio-
logical differences among these three regions of China were analyzed.
Due to possible changes in the epidemiology of sepsis related to
advances in healthcare accessibility in mainland China over time, the
included studies were categorized into three periods: 1990–1999,
2000–2004 and 2005–2009. If the observation duration of a study
covered two periods, the period containing the majority of the
observation duration was chosen.