Comparison of blood culture results and clinical biochemistry laboratory parameters in geriatric patients with regards to infective agents

Abstract

Aim: Bacterial infections can cause life-threatening sepsis and should be identified and managed accurately, especially in the elderly. We aim to examine the relationships between positive blood cultures, Gram staining pattern and biochemistry parameters, in particular, procalcitonin (ProCT) levels. Methods: This was a single center retrospective study, in which patients with positive blood cultures detected in Maltepe University Faculty of Medicine Research and Education Hospital were included. Two groups were formed according to age and evaluated with regards to bacterial Gram staining and biochemistry laboratory findings. Group 1 consisted of patients under 65 years of age (n=69) and Group 2 included those over 65 years of age (n=198). Results: Two hundred and sixty-seven episodes of bacteremia (Gram-negative: 49.43%, Gram-positive bacteremia: 50.56%) were evaluated in two groups. CRP values, lymphocyte and thrombocyte counts, creatinine, AST, ALT, albumin, CRP/albumin ratio values were similar between two groups (P>0.05 for all), while leukocyte counts, neutrophil counts and BUN values were lower in group 1 (P=0.020, P=0.020 and P<0.001 respectively) and ProCT levels were lower in group 2 (P=0.049). ProCT values (independent of age) had significantly increased in patients with Gram-negative bacteremia (P<0.001 in both group 1 and 2). Conclusion: ProCT measurement can be helpful as a distinguishing biomarker in different bloodstream infections, regardless of age.

Keywords

• bacteremia
• elderly
• procalcitonin

Geriatrik hastalarda kan kültürü sonuçları ile klinik biyokimya laboratuvar parametrelerinin enfeksiyon ajanlarına göre karşılaştırılması

Abstract

Amaç: Bakteriyel enfeksiyonlar yaşamı tehdit ederek sepsise neden olabilir ve özellikle yaşlılarda doğru bir şekilde tanı konmalı ve yönetilmelidir. Çalışmamızda kan kültürlerinde üreme olan hastaların, Gram boyama paterni ve biyokimya parametrelerinin, özellikle prokalsitonin (ProCT) seviyeleri temelinde incelenmesi amaçlanmıştır. Yöntemler: Tek merkezli retrospektif bu çalışmada, Maltepe Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi'nde kan kültürü pozitif olan hastalar çalışmaya dahil edildi. Altmış beş yaş altı genç grup (n=69) ve 65 yaş üstü yaşlı grup (n=198), bakteriyel Gram boyama ve biyokimya laboratuvar bulgularına göre tanımlandı ve değerlendirildi. Bulgular: 267 bakteriyemi epizodu (Gram negatif: %49,43 ve Gram pozitif: %50,56) iki ayrı yaş grubunda değerlendirildi. CRP değerleri, lenfosit ve trombosit sayıları, kreatinin, AST, ALT, albümin, CRP/albümin oranı değerleri iki grup arasında istatistiksel olarak anlamlı bulunmazken (P>0,05), lökosit sayıları (P=0,020), nötrofil sayıları (P=0,020) ve BUN değerleri (P<0,001) yaşlı grupta yüksek, ProCT seviyeleri ise düşük (P=0,049) olarak saptandı. ProCT değerleri (yaştan bağımsız olarak) Gram-negatif bakteriyemili hastalarda anlamlı olarak yüksek olarak ölçüldü (her iki grup için de P<0,001). Sonuç: Prokalsitonin ölçümü, yaşa bakılmaksızın farklı kan dolaşımı enfeksiyonlarında ayırt edici bir biyobelirteç olarak yardımcı olabilir.

Keywords

• Bakteriyemi
• Yaşlı
• Prokalsitonin

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