Evaluation of Blood Culture in Sari Hospitals

Objectives: 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 blood 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 drwan, were included. In the case that positive blood cultures were drwan more than 72 hours after the patients has been admitted to the hospital or if the patients had been recently discharged from the hospital the infection was classified as hospital-aquired. Severity of illness was categorized as non-fatal, ultimately-fatal and rapidly-fatal according to McCabe and Jackson groups. For determining the sesceptibility, Kirby-Bauer disk diffusion test was used and the results were reported. Results: the rate of positive blood culture associated with significant bacteremia and contamination were 43.4% and 21.7% respectively.of the 168 episodes of bacteremia, 70.8% were hospital-aquired and 29.2% were community-acquired. The most commonly isolated microorganisms were Staphylococci (49.6%), Escheria coli(19.3%), and Klebsiela(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. Fatal underlying diseases, severity of illness, sever sepsis, bladder and intravenous catheters, previous usages of antibiotics, previous surgery and tracheal in tubation were found to be associated with death in hospital-acquired infections. Conclusion: Nosocomial infections are more severing than others and antibiotics resistant bacteria will continue to challenge all who care for patients with blood stream infections.