Prospective evaluation of blood cultures in a Turkish university hospital: epidemiology, microbiology and patient outcome.
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.
Esel
D
D
Department of Microbiology, Faculty of Medicine, Erciyes University, 38039 Kayseri, Turkey. desel@hotmail.com
Doganay
M
M
Alp
E
E
Sumerkan
B
B
D016470:Bacteremia / Q000097:blood / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D001769:Blood / Q000382:microbiology*; D002006:Brucellosis / Q000097:blood / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D003428:Cross Infection / Q000097:blood / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D004927:Escherichia coli Infections / Q000097:blood / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000097:blood / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D014421:Turkey / Q000453:epidemiology