Prospective evaluation of blood cultures in a Turkish university hospital: epidemiology, microbiology and patient outcome
Prospective evaluation of blood cultures in a Turkish university hospital: epidemiology, microbiology and patient outcome
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DOI：
10.1046/j.1469-0691.2003.00714.x
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发表时间：
2003-10-01
影响因子：
14.2
通讯作者：
Sumerkan, B
中科院分区：
文献类型：
--
作者：
Esel, D;Doganay, M;Sumerkan, B
这项前瞻性研究的目的是：（1）确定血培养污染率;（2）描述和比较医院和社区获得性血流感染的流行病学、临床和微生物学特征;（3）确定血流感染导致的死亡率。真菌血症率为12.1%，10.7%的培养物被污染。在567例血流感染中，73.4%为医院获得性，26.6%为社区获得性。最常见的分离微生物是葡萄球菌（44%，耐甲氧西林69.4%），肠球菌（15%）和大肠埃希菌（12.5%）在医院获得性发作，布鲁氏菌属。(21.9%）、E.大肠埃希菌（19.2%）和金黄色葡萄球菌（14.6%），耐甲氧西林9.1%。虽然总体死亡率为25.4%，但在医院获得性事件中，血液感染导致的死亡率为16.6%，在社区获得性事件中为13.9%。在医院获得性发作中，铜绿假单胞菌引起的菌血症患者死亡率最高（37.5%），在社区获得性发作中，肺炎链球菌引起的菌血症患者死亡率最高（50%）。基础疾病、疾病严重程度、膀胱导管的存在、先前使用抗生素、气管插管和充分治疗被发现与死亡显著相关。
The aims of this prospective study were to: (1) determine the rate of blood culture contamination; (2) describe and compare the epidemiologic, clinical and microbiological characteristics of hospital- and community-acquired bloodstream infections; and (3) determine the mortality resulting from bloodstream infections. The rate of true bacteremia was 12.1%, and 10.7% of cultures were contaminated. Of the 567 episodes of bloodstream infection, 73.4% were hospital-acquired, and 26.6% were community-acquired. The most commonly isolated microorganisms were staphylococci (44%, methicillin resistant 69.4%), enterococci (15%) and Escherichia coli (12.5%) in hospital-acquired episodes, and Brucella spp. (21.9%), E. coli (19.2%) and Staphylococcus aureus (14.6%, methicillin resistant 9.1%) in community-acquired episodes. While the overall mortality rate was 25.4%, death attributable to bloodstream infections was 16.6% in hospital-acquired episodes and 13.9% in community-acquired episodes. The highest mortality occurred in patients with bacteremia due to Pseudomonas aeruginosa (37.5%) in hospital-acquired episodes, and in patients with bacteremia due to Streptococcus pneumoniae (50%) in community-acquired episodes. Underlying diseases, severity of illness, presence of bladder catheter, previous use of antibiotics, tracheal intubation and adequacy of treatment were found to be significantly associated with death.