الفهرس | Only 14 pages are availabe for public view |
Abstract Blood stream infection is one of the most common clinical problems confronting physicians worldwide. It usually implicates a disseminated infectious process associated with increased morbidity, mortality, and costs. Traditionally, BSI has been divided into community and nosocomial episodes. A proposal was made to further subdivide community-onset BSI into healthcare-associated Discussion 91 (HCA) episodes for patients with significant recent healthcare contact and procedures, and strictly community-acquired (CA) episodes for patients without. The spectrum of organisms causing bacteremia has changed over the years. Infections due to Gram-positive organisms have become increasingly frequent.So, prompt, accurate detection and identification of bloodstream pathogens are essential for optimal management of patients. A total of 45specimens were collected from Beni-Suef University Hospital in six months period .They were divided into 2 groups:- group (1) 25 pediatric specimens were collected on isolator 1.5 blood culture system and on manual pediatric blood culture bottles to compare results. Specimens on isolator had been processed as soon as they were received in the laboratory.Specimens were divided evenly among the primary isolation media.Specimens on manual pediatric blood culture bottles were incubated aerobically at 37°C for 7 days. The bottles were examined daily for evidence of bacterial growth. Subcultures were done on blood agar, chocolate agar, Macconkey’s agar daily for 7 days before reporting blood cultures as negative. group (2) 20 adult specimens were collected on signal blood culture system.After incubation,identification was done using blood agar, chocolate agar, Macconkey agar and manual biochemical tests. Antibiotic sensitivity testing was done using the disk-diffusion method on Mueller-Hinton Agar. The observed blood culture positivity rate was 33.3% andchildren prevalence of BSI was 36%.Gram-positive bacteria represented66.7% of BSI while gram-negative bacteria represented33.3%. Among the bacterial pathogens, the most common bacterial isolates were: coagulase negative Staphylococci (CoNS)(33.3%), Staphylococcus aureus (S.aureus) (26.7%), Acintobacter(20%), Klebsiella spp.(6.7%), Pseudomonas aeruginosa (P. aeruginosa) (6.7%) and Corynebacterium species(6.7%).Three cases (75%) of the four S. a u r e u s i s o l a t e s w e r e d i a g n o s e d a s M R S A . Discussion 91 Isolator blood culture is fast and more sensitive in predicting bacteremia than manual blood culture bottle. We found that (11/15)73.3% hospital acquired, (3/15)20% community acquired and(1/15) 6.7% health care associated BSI.And the most frequent source of nosocomial bacteremia was intravenous catheter, accounting for almost(8/11) 72.7% of the hospital acquired cases and for almost (9/15) 60% of all episodes. |