Prospective evaluation of blood cultures in a Turkish university hospital: epidemiology, microbiology and patient outcome

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ESEL D., Doganay M., ALP E., SUMERKAN B.

CLINICAL MICROBIOLOGY AND INFECTION, vol.9, no.10, pp.1038-1044, 2003 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 9 Issue: 10
  • Publication Date: 2003
  • Doi Number: 10.1046/j.1469-0691.2003.00714.x
  • Journal Name: CLINICAL MICROBIOLOGY AND INFECTION
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1038-1044
  • Keywords: blood culture, bloodstream infection, antimicrobial resistance, ANTIMICROBIAL SURVEILLANCE PROGRAM, STREAM INFECTIONS, UNITED-STATES, BACTEREMIA, ORGANISMS, SUSCEPTIBILITY, FREQUENCY
  • Lokman Hekim University Affiliated: No

Abstract

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.