Evaluation of blood cultures in Sari Hospitals

Abstract EN

Objective : The aim of this study was to determine the rate of blood culture contamination, to describe and compare the epidemiologic, clinical and microbiological characteristics of hospital-and community-acquired stream infections.

Methods: In this survey during one year (2002-2003) all patients over 18 years of age admitted in different hospitals for whom blood culture were drawn, were included.

In the cases that positive blood cultures were drawn more than 72houra after the patients had been admitted to the hospital or if the patients had been recently discharged from the hospital the infection was classified as hospital-acquired.

If the cultures were drawn within 72 hours after admission to the hospital, the infection was classified as community-acquired.

Severity of illness was categorized as non-fatal, ultimately-fatal, and rapidly-fatal according to McCabe and Jackson groups.

For determining the susceptibility of isolated bacteria to the used antibiotics in the hospitals, Kirby-Bauer disk diffusion test was used and the results were reported.

Results : The rates of positive blood cultures associated with significant bacteremia and contamination were 43.4 %, and 21.7 % respectively.

Of the 168 episodes of bacteremia, 70.8 % were hospital-acquired, and 29.2 % were community-acquired.

The most commonly isolated microorganisms were Staphylococci (49.6 %), Escherichia coli (19.3 %) and Klebsiella (16 %) in hospital-acquired infection, and Pneumococci (24.5 %), Brucella spp (20.4 %) and Escherichia coli (16.3 %) in community-acquired episodes.

Mortality rate was 26.5 % in hospital acquired and 17.2 % in community-acquired infections.

Fetal underlying diseases, severity of illness, severe sepsis, bladder and intravenous catheters, severity of illness, severe sepsis, bladder and intravenous catheters, previous usage of antibiotics, previous surgery and tracheal intubation were found to be associated with death in hospital-acquired infections.

Conclusion : Nosocomial infections are more severe than others and antibiotic resistant bacteria will continue to challenge all who care for patients with blood stream infections.