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Importance of quality management system in blood culture: Contamination rates

Year 2021, Volume: 12 Issue: 4, 446 - 450, 22.12.2021
https://doi.org/10.18663/tjcl.795926

Abstract

Aim: Diagnosis of bloodstream infections is very important for microbiology. Determining the correct agent by minimizingcontamination directly affects morbidity and mortality. In this study, it was aimed to
determine the preanalytical factors causing contamination in blood cultures.
Material and Methods: The samples that sent to Microbiology Laboratory between 17.05.2017-08.11.2019 were added to automated blood culture. Reproductive signal samples were stained and bacterial cultures were made.
Results: Bacterial growth was detected in 82 (15.7%) of 5215 culture samples. 425 (8.15%) of the samples were contaminants. This rate were 8.7% in women; 7.8% in men. In age groups, the ratio was highest above the age of 18(9.3%); It was the lowest at the age of 5-18(3.4%). In services, the rate of contamination in intensive care units was highest (13.8%).
Conclusion: Contamination is the growth in culture, although there is no organism in the blood. The most important reason is the inoculation of microorganisms in the skin flora into culture bottles. Hospital environment, microorganisms that colonize the catheter, the hands of the staff who take the blood and
the equipment used to take culture can alsobe a source of contamination. In our study, contamination rates were high and we found the difference between age groups and services significant In order to reduce the contamination rates, blood should be taken by a trained healthcare professional, an effective skin antisepsis should be applied and sample should not be taken from the intravenous catheter.

References

  • 1.Kaye KS, Marchaim D, Chen TY, et al. Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults. J Am Geriatr Soc, 2014; 62: 306-11.
  • 2. Lambert ML, Suetens C, Savey A, et al. Clinical outcomes of health-care-associated infections and antimicrobial resistance in patients admitted to European intensive-care units: a cohort study. Lancet Infect Dis, 2011; 1: 30-8.
  • 3. Jian-nong WU, Tie-er GAN, Yue-xian ZHU, et al. Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study. Biomed & Biotechnol, 2015; 16: 70-7.
  • 4. Ntusi N, Aubin L, Oliver S, et al. Guideline for the optimal use of blood cultures. S Afr Med J 2010; 100: 839-43.
  • 5. Chiarini A, Palmeri A, Amato T, et al. Detection of bacterial and yeast species with the Bactec 9120 automated system with routine use of aerobic, anaerobic, and fungal media. J Clin Microbiol 2008; 46: 4029-33.
  • 6. Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006; 19: 788-802.
  • 7. Kan kültürü uygulama kılavuzu Ahmet Başustaoğlu 2013;11.
  • 8. Tıbbi mikrobiyoloji uzmanları için klinik örnekten sonuç raporuna uygulama rehberi kan dolaşımı örnekleri eylül 2017; 16.
  • 9. Anonymous. Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; Twenty First Informational Supplement. M100-S25. ISBN: 1-56238-989-0, Wayne, CLSI, 2015.
  • 10. Sogaard M, Norgaard M, Dethlefsen C, et al. Temporal changes in the incidence and 30- day mortality associated with bacteremia in hospitalized patients from 1992 through 2006: a populationbased cohort study. Clin Infect Dis, 2011; 52: 61–9.
  • 11. Sharma DK, Tiwari YK, Vyas N, et al. An investigation of the incidence of nosocomial infections among the patients admitted in the intensive care unit of a tertiary care hospital in Rajasthan. Int J Curr Microbiol, 2013; 2: 428- 35.
  • 12. Fram D, Okuno MFP, Taminato M, et al. Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study. BMC Infect Dis. 2015; 15: 158.
  • 13. Durmaz G, Us T, Aydinli A, et al. Optimum detection times for bacteria and yeast species with the BACTEC 9120 aerobic blood culture system: evaluation for a 5-year period in a Turkish university hospital. J Clin Microbiol 2003; 41: 819-21.
  • 14. Janjindamai W, Phetpisal S. Time to positivity of blood culture in newborn infants. Southeast Asian J Trop Med Public Health 2006; 37: 171-6.
  • 15. Gopi A, Ravikumar KL, Ambarish MG, et al. Time to positivity of microorganisms with BACTEC 9050: an 18-month study among children of 28 days to 60 months in an South Indian tertiary hospital. Intl J Microbiol Res 2011; 2: 12-7.
  • 16. Roh KH, Kim JY, Kim HN, et al. Evaluation of BACTEC Plus aerobic and anaerobic blood culture bottles and BacT/Alert FAN aerobic and anaerobic blood culture bottles for the detection of bacteremia in ICU patients. Diagn Microbiol Infect Dis, 2012; 73: 239-42.
  • 17. Arif Al-Hamad, Maha El-İbrahim, Eman Alhajhouj, et al. Nurses’ competency in drawing blood cultures and educational intervention to reduce the contamination rate. Journal of Infection and Public Health, 2016; 1: 66-74
  • 18. Goto M, Al-Hasan MN. Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe. Clin Microbiol Infect, 2013; 19: 501-9.
  • 19. R. S. Nannan Panday, S. WangP. M. van de Ven, T. A. M. Hekker, N. Alam, P. W. B. Nanayakkara. Evaluation of blood culture epidemiology and efficiency in a large European teaching hospital Published: March 21, 2019 https://doi.org/10.1371/ journal.pone.0214052

Kan kültüründe kalite yönetim sisteminin önemi: Kontaminasyon oranları

Year 2021, Volume: 12 Issue: 4, 446 - 450, 22.12.2021
https://doi.org/10.18663/tjcl.795926

Abstract

Amaç: Kan dolaşımı enfeksiyonlarının tanısı, klinik mikrobiyoloji laboratuvarlarının en acil ve önemli görevlerinden biridir. Kontaminasyonu en aza indirerek doğru etkenin saptanması morbidite ve mortaliteyi doğrudan etkilemektedir. Bu çalışmamızda, kan kültürlerinde kontaminasyona neden olan preanalitik etkenlerin belirlenmesi amaçlanmıştır.
Gereç ve Yöntemler: * Mikrobiyoloji Laboratuvarına 17.05.2017-08.11.2019 tarihleri arasında gelen örnekler otomatize kan kültürüne ekildi. Üreme sinyali veren örnekler boyama sonrası bakteriyel kültür yapılarak otomatize sistemle identifikasyon ve antibiyograma alındı. Sonuçlar kan dolaşım yolu enfeksiyonuna neden olduğu bilinen etkenler ve kontaminantlar açısından analiz edildi.
Bulgular: Toplam 5215 kan kültür örneğinin 821 (%15,7)’nde üreme saptandı. Örneklerin 425 (%8,15)’i kontaminant olarak rapor edildi. Kontaminasyon oranı kadınlarda %8,7; erkeklerde %7,8 idi. Yaş gruplarına göre kıyaslandığında oran 18 yaş üstü grupta en yüksek (%9,3) iken 5-18 yaş grubunda en düşüktü (%3,4). Servis olarak Yoğun Bakımlarda kontaminasyon oranının en fazla (%13,8) olduğu görüldü.
Sonuç: Kontaminasyon; kanda organizma olmadığı halde kültürde üreme olması durumudur ve en önemli nedeni, cilt florasında bulunan mikroorganizmaların kan kültürü şişelerine inokülasyonudur. Hastane ortamı, kateteri kolonize eden mikroorganizmalar, kanı alan personelin elleri ve kültür alımında kullanılan ekipmanlar da kontaminasyon kaynağı olabilir. Bizim çalışmamızda kontaminasyon oranlarını yüksekti ve yaş grupları ile servisler arasındaki fark anlamlı bulduk. Kontaminasyon oranlarının düşürülmesi için kan eğitimli bir sağlık personeli tarafından alınmalı, etkin bir cilt antisepsisi uygulanmalı ve intravenöz kataterden örnek alınmamalıdır.

References

  • 1.Kaye KS, Marchaim D, Chen TY, et al. Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults. J Am Geriatr Soc, 2014; 62: 306-11.
  • 2. Lambert ML, Suetens C, Savey A, et al. Clinical outcomes of health-care-associated infections and antimicrobial resistance in patients admitted to European intensive-care units: a cohort study. Lancet Infect Dis, 2011; 1: 30-8.
  • 3. Jian-nong WU, Tie-er GAN, Yue-xian ZHU, et al. Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study. Biomed & Biotechnol, 2015; 16: 70-7.
  • 4. Ntusi N, Aubin L, Oliver S, et al. Guideline for the optimal use of blood cultures. S Afr Med J 2010; 100: 839-43.
  • 5. Chiarini A, Palmeri A, Amato T, et al. Detection of bacterial and yeast species with the Bactec 9120 automated system with routine use of aerobic, anaerobic, and fungal media. J Clin Microbiol 2008; 46: 4029-33.
  • 6. Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006; 19: 788-802.
  • 7. Kan kültürü uygulama kılavuzu Ahmet Başustaoğlu 2013;11.
  • 8. Tıbbi mikrobiyoloji uzmanları için klinik örnekten sonuç raporuna uygulama rehberi kan dolaşımı örnekleri eylül 2017; 16.
  • 9. Anonymous. Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; Twenty First Informational Supplement. M100-S25. ISBN: 1-56238-989-0, Wayne, CLSI, 2015.
  • 10. Sogaard M, Norgaard M, Dethlefsen C, et al. Temporal changes in the incidence and 30- day mortality associated with bacteremia in hospitalized patients from 1992 through 2006: a populationbased cohort study. Clin Infect Dis, 2011; 52: 61–9.
  • 11. Sharma DK, Tiwari YK, Vyas N, et al. An investigation of the incidence of nosocomial infections among the patients admitted in the intensive care unit of a tertiary care hospital in Rajasthan. Int J Curr Microbiol, 2013; 2: 428- 35.
  • 12. Fram D, Okuno MFP, Taminato M, et al. Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study. BMC Infect Dis. 2015; 15: 158.
  • 13. Durmaz G, Us T, Aydinli A, et al. Optimum detection times for bacteria and yeast species with the BACTEC 9120 aerobic blood culture system: evaluation for a 5-year period in a Turkish university hospital. J Clin Microbiol 2003; 41: 819-21.
  • 14. Janjindamai W, Phetpisal S. Time to positivity of blood culture in newborn infants. Southeast Asian J Trop Med Public Health 2006; 37: 171-6.
  • 15. Gopi A, Ravikumar KL, Ambarish MG, et al. Time to positivity of microorganisms with BACTEC 9050: an 18-month study among children of 28 days to 60 months in an South Indian tertiary hospital. Intl J Microbiol Res 2011; 2: 12-7.
  • 16. Roh KH, Kim JY, Kim HN, et al. Evaluation of BACTEC Plus aerobic and anaerobic blood culture bottles and BacT/Alert FAN aerobic and anaerobic blood culture bottles for the detection of bacteremia in ICU patients. Diagn Microbiol Infect Dis, 2012; 73: 239-42.
  • 17. Arif Al-Hamad, Maha El-İbrahim, Eman Alhajhouj, et al. Nurses’ competency in drawing blood cultures and educational intervention to reduce the contamination rate. Journal of Infection and Public Health, 2016; 1: 66-74
  • 18. Goto M, Al-Hasan MN. Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe. Clin Microbiol Infect, 2013; 19: 501-9.
  • 19. R. S. Nannan Panday, S. WangP. M. van de Ven, T. A. M. Hekker, N. Alam, P. W. B. Nanayakkara. Evaluation of blood culture epidemiology and efficiency in a large European teaching hospital Published: March 21, 2019 https://doi.org/10.1371/ journal.pone.0214052
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Nuray Arı 0000-0001-9983-5021

Neziha Yılmaz 0000-0001-9027-079X

Emine Yeşilyurt 0000-0002-6100-0480

Publication Date December 22, 2021
Published in Issue Year 2021 Volume: 12 Issue: 4

Cite

APA Arı, N., Yılmaz, N., & Yeşilyurt, E. (2021). Kan kültüründe kalite yönetim sisteminin önemi: Kontaminasyon oranları. Turkish Journal of Clinics and Laboratory, 12(4), 446-450. https://doi.org/10.18663/tjcl.795926
AMA Arı N, Yılmaz N, Yeşilyurt E. Kan kültüründe kalite yönetim sisteminin önemi: Kontaminasyon oranları. TJCL. December 2021;12(4):446-450. doi:10.18663/tjcl.795926
Chicago Arı, Nuray, Neziha Yılmaz, and Emine Yeşilyurt. “Kan kültüründe Kalite yönetim Sisteminin önemi: Kontaminasyon Oranları”. Turkish Journal of Clinics and Laboratory 12, no. 4 (December 2021): 446-50. https://doi.org/10.18663/tjcl.795926.
EndNote Arı N, Yılmaz N, Yeşilyurt E (December 1, 2021) Kan kültüründe kalite yönetim sisteminin önemi: Kontaminasyon oranları. Turkish Journal of Clinics and Laboratory 12 4 446–450.
IEEE N. Arı, N. Yılmaz, and E. Yeşilyurt, “Kan kültüründe kalite yönetim sisteminin önemi: Kontaminasyon oranları”, TJCL, vol. 12, no. 4, pp. 446–450, 2021, doi: 10.18663/tjcl.795926.
ISNAD Arı, Nuray et al. “Kan kültüründe Kalite yönetim Sisteminin önemi: Kontaminasyon Oranları”. Turkish Journal of Clinics and Laboratory 12/4 (December 2021), 446-450. https://doi.org/10.18663/tjcl.795926.
JAMA Arı N, Yılmaz N, Yeşilyurt E. Kan kültüründe kalite yönetim sisteminin önemi: Kontaminasyon oranları. TJCL. 2021;12:446–450.
MLA Arı, Nuray et al. “Kan kültüründe Kalite yönetim Sisteminin önemi: Kontaminasyon Oranları”. Turkish Journal of Clinics and Laboratory, vol. 12, no. 4, 2021, pp. 446-50, doi:10.18663/tjcl.795926.
Vancouver Arı N, Yılmaz N, Yeşilyurt E. Kan kültüründe kalite yönetim sisteminin önemi: Kontaminasyon oranları. TJCL. 2021;12(4):446-50.


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