TY  - JOUR
TT  - PERİFERİK KAN KÜLTÜRÜ VE YÖNETİMİ
AU  - Ardahan Sevgili, Seda
AU  - Yardımcı, Figen
PY  - 2017
DA  - December
Y2  - 2017
JF  - Ege Üniversitesi Hemşirelik Fakültesi Dergisi
JO  - EGEHFD
PB  - Ege Üniversitesi
WT  - DergiPark
SN  - 2147-3463
SP  - 153
EP  - 162
VL  - 33
IS  - 2
KW  - yalancı-pozitif
KW  - kan dolaşımı enfeksiyonu
KW  - enfeksiyon kontrolü
N2  - Başlık: PERİFERİK KAN KÜLTÜRÜ VE YÖNETİMİTitle: PERIPHERALBLOOD CULTURE AND MANAGEMENTÖzet: Kandolaşımı enfeksiyonları; enfeksiyona neden olan mikroorganizma ile etkilediğicanlı arasında birçok etkileşim sonucunda meydana gelen ve oldukça karmaşık birsüreçtir. Bundan dolayı kan dolaşımı enfeksiyonlarının erken dönemdetanılanması ve tanısına yönelik tedavisinin başlatılması yaşamsal önemtaşımaktadır. Kan kültürleri; ciddi kan dolaşımı enfeksiyonlarının tanımlanmasıve uygun antimikrobiyal tedavinin seçiminde kullanılan tanılama testlerinin enönemlisidir. Teknolojinin gelişmesiyle birlikte, her geçen gün tanı ve tedavitekniklerinde yeni gelişmeler olmaktadır, ancak; bakteriyemi ve fungeminintespitinde kan kültürleri hala en uygun teknik olma niteliğini sürdürmektedir. Periferik kan kültürü alımı yaparken sağlıkçalışanlarının dikkat etmesi gereken durumlardan biri deri kontaminasyonunabağlı yalancı-pozitif kan kültürüdür. Yalancı-pozitif kan kültürlerinin hemtedavi görmekte olan hastalar hem de sağlık sistemi açısından oldukça fazlaolumsuz etkisi bulunmaktadır. Test sonuçlarının yalancı-pozitif olduğu farkedilmez ise, sağlık çalışanları tarafından aslında gerekli olmayan çok sayıdatanı-tedavi yöntemi uygulanmak zorunda kalınmaktadır.Abstract: Bloodstreaminfection is a very complicated process that occurs as a result of manyinteractions between the infecting microorganism and the living organism.Therefore, it is essential to initiate early diagnosis of bloodstreaminfections and treatment. Blood cultures are the most important diagnostictests used for identification of severe bloodstream infections and selection ofappropriate antimicrobial therapy. With the development of technology, thereare new developments in diagnosis and treatment techniques every passing daybut; blood cultures still remain the most appropriate technique for the detectionof bacteraemia and fungemia. One of the situations that health care workersshould be aware of when taking peripheral blood culture is a false-positiveblood culture due to skin contamination. False-positive blood cultures haveconsiderable negative effects on both the treated patients and the healthsystem. If it is not noticed that the test results are false-positive, a largenumber of diagnostic and therapeutic methods that are not actually needed haveto be done by healthcare professionals. Anahtar kelimeler: yalancı-pozitif, kan dolaşımı enfeksiyonu,enfeksiyon kontrolüKeywords: false-positive,bloodstream infection, infection controlDestekleyen kurumlar:Kaynakça: Alahmadi YM, McElnay JC, Kearney MP ve ark. Tackling theproblem of blood culture contamination in the intensive care unit using aneducational intervention. Epidemiology&Infection 2015;143(9):1964-1971.Bekeris LG, Tworek JA,Walsh MK ve ark. Trends in blood culture contamination: a college of americanpathologists q-tracks study of 356 institutions. Archives of Pathology&LaboratoryMedicine 2005;129:1222–1225.Boyce JM, Nadeau J,Dumigan D ve ark. Obtaining blood cultures by venipuncture versus from centrallines: ımpact on blood culture contamination rates and potential effect oncentral line–associated bloodstream infection reporting. Infection Control andHospital Epidemiology 2013;34(10):1042104-7.Chang YT, Lin CY, Lu PLve ark. Stenotrophomonas maltophilia bloodstream infection: comparison betweencommunity-onset and hospital-acquired infections. Journal of Microbiology,Immunology and Infection 2014;47:28-35.Clinical and Laboratory Standards Institute (CLSI). Principles And Procedures For Blood Cultures;Approved Guideline. CLSI Document M47-A. Clinical & Laboratory Standards Institute 2007;27(17); [cited 2016 February 3]. Available frrom: http://shop.clsi.org/site/Sample_pdf/M47A_sample.pdf.Cockerill FR III, Wilson JW, Vetter EA ve ark. Optimal testing parametersfor blood cultures. Clinical Infectious Disease 2004; 38(12):1724-1730.Çiçek A. Kan kültürsonuçlarının değerlendirilmesinde etkili olan faktörler. İnönü Üniversitesi TıpFakültesi Dergisi 2005;12(4):277-280.Çöloğlu D. Yalancı Pozitif Üreme Sinyali Veren Otomatize Kan KültürüŞişelerinde Polimeraz Zincir Reaksiyonu (Pzr) Yöntemi İle Bakteri ve MantarVarlığının Araştırılması. [Tıpta Uzmanlık Tezi]. Ankara: AnkaraÜniversitesi Tıp Fakültesi; 2012.Gander RM, Byrd L,DeCrescenzo M  ve ark. Impact of bloodcultures drawn by phlebotomy on contamination rates and health care costs in ahospital emergency department. Journal of Clinical Microbiology2009;47(4):1021-4Gilligan PH. Blood culture contamination: a clinical and financialburden. Infection Control&Hospital Epidemiology 2013;34(1):22-23.Hall KK, Lyman JA. Updated review of blood culture contamination.Clinical Microbiology Reviews 2006;19:788-802.Harbarth S, Garbino J,Pugin J ve ark. Inappropriate initial antimicrobial therapy and its effect onsurvival in a clinical trial of immunomodulating therapy for severe sepsis.American Journal of Medicine 2003;115:529-535.Isenberg HD. Clinical Microbiology Procedures Handbook [e-book].Washington, DC: ASM Press; 2004. [cited2016 January 10]. Available from:  http://en.bookfi.net/book/1306334.Lee A, Mirrett S, Reller LB ve ark. Detection of bloodstream infectionsin adults: how many blood cultures are needed? Journal of Clinical Microbiology2007;45(11):3546-3548.Liu W, Duan Y, Cui W ve ark. Skin antiseptics in venous puncturesite disinfection for preventing blood culture contamination: a bayesiannetwork meta-analysis of randomized controlled trials. International Journal ofNursing Studies 2016;59:156-162.Maiwald M, Chan SY. Pitfalls in evidence assessment: the case ofchlorhexidine and alcohol in skin antisepsis. Journal of AntimicrobialChemotheraphy 2014;69(8):2017-2021.Maiwald M, Chan SY. The forgotten role of alcohol: a systematic reviewand meta-analysis of the clinical efficacy and perceived role of chlorhexidinein skin antisepsis. PLoS One 2012;7(9):e44277. Murphy T, Maile D,Barsch T. Investigating the ımpact of blood culture bundles on the incidence ofblood culture contamination rates, TheArt And Science of Infusion Nursing 2014;37(3):205-210.Murray PR, Masur H. Current approaches to the diagnosis of bacterial andfungal bloodstream infections in the intensive care unit. Critical CareMedicine 2012;40:3277-3282.Murty DS, Gyaneshwari M. Blood cultures inpaediatric patients: a study of clinical impact. Indian Journal of MedicalMicrobiology 2007;25(3):2022-2024.Mylotte JM, Tayara A.Blood culture: clinical aspects and controversies. EuropeanJournal of Clinical Microbiology&Infectious Diseases2000;19:157-163.O’Connor C, Philip RK, Powell J ve ark. Combined education and skinantisepsis intervention for persistently high blood-culture contamination ratesin neonatal intensive care. Journal of Hospital Infection 2016; 93(1):105-107.Pavlovsky M, Press J,Peled N ve ark. Blood culture contamination in pediatric patients: youngchildren and young doctors. The Pediatric Infectious Disease Journal2006;25(7):611–614.Pien BC, Sundaram P,Raoof N ve ark.  The clinical andprognostic importance of positive blood cultures in adults. The AmericanJournal of Medicine 2010;123(9):819-828.Self HW,  Mickanin J, Grijalva CG veark. Reducing blood culture contamination in communityhospital emergency departments: multicenter evaluation of a quality improvementintervention, Academic EmergencyMedicine 2014;21(3):274–282.Self HW, Speroff T,McNaughton CD ve ark. Blood culture collection through peripheral intravenouscatheters increases the risk of specimen contamination among adult emergencydepartment patients. Infection Control and Hospital Epidemiology2012;33(5):524-526.  Singhal T. Blood cultures revisited. Pediatric Infectious Disease 2012;4(1):25–27.Smith BA, Peterson LR. Best way to preventblood culture contamination. Medscape 2014 SHEA Expert commentaries.Snyder JW. Blood cultures: The importance ofmeeting pre-analytical requirements in reducing contamination, optimizing sensitivityof detection, and clinical relevance, Clinical Microbiology Newsletter2015;37(7):53-57.Stonecypher K. Going around in circles. Critical Care Nursing 2009;32:94-98.Taneja D, Finney J, Nagaishi K. A performance improvement project:reducing emergency department blood culture contamination rate using six sigmamethodology. American Journal of Infection Control 2014; 42: 29-166Towns ML, Jarvis WR, Hsueh P. Guidelines on blood cultures. journal of microbiology,İmmunology anf Infection 2010;43(4):347-349.Wanga P, Hub B.Strategies on reducing blood culture contamination, Reviews in MedicalMicrobiology 2012;(23):63–66.Willock J, RichardsonJ, BrazierAve ark. Peripheral venepuncture in infants and children. Nursing Standard2004;18(27):43-50.YoussefD, Shams W, Bailey B ve ark. Effective strategy for decreasing blood culturecontamination rates: the experience of a veterans affairs medical centre.Journal of Hospital Infection 2012;81:288-291.Zarbo RJ, Jones BA, Friedberg RC veark. Q-tracks:a College of American Pathologists program of continuous laboratory monitoringand longitudinal tracking. Archives of Pathology& Laboratory Medicine2002;126:1036-1044.
CR  - Alahmadi YM, McElnay JC, Kearney MP ve ark. Tackling the problem of blood culture contamination in the intensive care unit using an educational intervention. Epidemiology&Infection 2015;143(9):1964-1971.
CR  - Bekeris LG, Tworek JA, Walsh MK ve ark. Trends in blood culture contamination: a college of american pathologists q-tracks study of 356 institutions. Archives of Pathology&Laboratory Medicine 2005;129:1222–1225.
CR  - Boyce JM, Nadeau J, Dumigan D ve ark. Obtaining blood cultures by venipuncture versus from central lines: ımpact on blood culture contamination rates and potential effect on central line–associated bloodstream infection reporting. Infection Control and Hospital Epidemiology 2013;34(10):1042104-7.
CR  - Chang YT, Lin CY, Lu PL ve ark. Stenotrophomonas maltophilia bloodstream infection: comparison between community-onset and hospital-acquired infections. Journal of Microbiology, Immunology and Infection 2014;47:28-35.
CR  - Clinical and Laboratory Standards Institute (CLSI). Principles And Procedures For Blood Cultures; Approved Guideline. CLSI Document M47-A. Clinical & Laboratory Standards Institute 2007;27(17); [cited 2016 February 3]. Available frrom: http://shop.clsi.org/site/Sample_pdf/M47A_sample.pdf.
CR  - Cockerill FR III, Wilson JW, Vetter EA ve ark. Optimal testing parameters for blood cultures. Clinical Infectious Disease 2004; 38(12):1724-1730.
CR  - Çiçek A. Kan kültür sonuçlarının değerlendirilmesinde etkili olan faktörler. İnönü Üniversitesi Tıp Fakültesi Dergisi 2005;12(4):277-280.
CR  - Çöloğlu D. Yalancı Pozitif Üreme Sinyali Veren Otomatize Kan Kültürü Şişelerinde Polimeraz Zincir Reaksiyonu (Pzr) Yöntemi İle Bakteri ve Mantar Varlığının Araştırılması. [Tıpta Uzmanlık Tezi]. Ankara: Ankara Üniversitesi Tıp Fakültesi; 2012.
CR  - Gander RM, Byrd L, DeCrescenzo M  ve ark. Impact of blood cultures drawn by phlebotomy on contamination rates and health care costs in a hospital emergency department. Journal of Clinical Microbiology 2009;47(4):1021-4
CR  - Gilligan PH. Blood culture contamination: a clinical and financial burden. Infection Control&Hospital Epidemiology 2013;34(1):22-23.
CR  - Hall KK, Lyman JA. Updated review of blood culture contamination. Clinical Microbiology Reviews 2006;19:788-802.
CR  - Harbarth S, Garbino J, Pugin J ve ark. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. American Journal of Medicine 2003;115:529-535.
CR  - Isenberg HD. Clinical Microbiology Procedures Handbook [e-book]. Washington, DC: ASM Press; 2004. [cited 2016 January 10]. Available from:  http://en.bookfi.net/book/1306334.
CR  - Lee A, Mirrett S, Reller LB ve ark. Detection of bloodstream infections in adults: how many blood cultures are needed? Journal of Clinical Microbiology 2007;45(11):3546-3548.
CR  - Liu W, Duan Y, Cui W ve ark. Skin antiseptics in venous puncture site disinfection for preventing blood culture contamination: a bayesian network meta-analysis of randomized controlled trials. International Journal of Nursing Studies 2016;59:156-162.
CR  - Maiwald M, Chan SY. Pitfalls in evidence assessment: the case of chlorhexidine and alcohol in skin antisepsis. Journal of Antimicrobial Chemotheraphy 2014;69(8):2017-2021.
CR  - Maiwald M, Chan SY. The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. PLoS One 2012;7(9):e44277.
CR  - Murphy T, Maile D, Barsch T. Investigating the ımpact of blood culture bundles on the incidence of blood culture contamination rates, The Art And Science of Infusion Nursing 2014;37(3):205-210.
CR  - Murray PR, Masur H. Current approaches to the diagnosis of bacterial and fungal bloodstream infections in the intensive care unit. Critical Care Medicine 2012;40:3277-3282.
CR  - Murty DS, Gyaneshwari M. Blood cultures in paediatric patients: a study of clinical impact. Indian Journal of Medical Microbiology 2007;25(3):2022-2024.
CR  - Mylotte JM, Tayara A. Blood culture: clinical aspects and controversies. European Journal of Clinical Microbiology&Infectious Diseases 2000;19:157-163.
CR  - O’Connor C, Philip RK, Powell J ve ark. Combined education and skin antisepsis intervention for persistently high blood-culture contamination rates in neonatal intensive care. Journal of Hospital Infection 2016; 93(1):105-107.
CR  - Pavlovsky M, Press J, Peled N ve ark. Blood culture contamination in pediatric patients: young children and young doctors. The Pediatric Infectious Disease Journal 2006;25(7):611–614.
CR  - Pien BC, Sundaram P, Raoof N ve ark.  The clinical and prognostic importance of positive blood cultures in adults. The American Journal of Medicine 2010;123(9):819-828.
CR  - Self HW,  Mickanin J, Grijalva CG ve ark. Reducing blood culture contamination in community hospital emergency departments: multicenter evaluation of a quality improvement intervention, Academic Emergency Medicine 2014;21(3):274–282.
CR  - Self HW, Speroff T, McNaughton CD ve ark. Blood culture collection through peripheral intravenous catheters increases the risk of specimen contamination among adult emergency department patients. Infection Control and Hospital Epidemiology 2012;33(5):524-526.
CR  - Singhal T. Blood cultures revisited. Pediatric Infectious Disease 2012;4(1):25–27.
CR  - Smith BA, Peterson LR. Best way to prevent blood culture contamination. Medscape 2014 SHEA Expert commentaries.
CR  - Snyder JW. Blood cultures: The importance of meeting pre-analytical requirements in reducing contamination, optimizing sensitivity of detection, and clinical relevance, Clinical Microbiology Newsletter 2015;37(7):53-57.
CR  - Stonecypher K. Going around in circles. Critical Care Nursing 2009;32:94-98.
CR  - Taneja D, Finney J, Nagaishi K. A performance improvement project: reducing emergency department blood culture contamination rate using six sigma methodology. American Journal of Infection Control 2014; 42: 29-166
CR  - Towns ML, Jarvis WR, Hsueh P. Guidelines on blood cultures. journal of microbiology, İmmunology anf Infection 2010;43(4):347-349.
CR  - Wanga P, Hub B. Strategies on reducing blood culture contamination, Reviews in Medical Microbiology 2012;(23):63–66.
CR  - Willock J, Richardson J, Brazier A ve ark. Peripheral venepuncture in infants and children. Nursing Standard 2004;18(27):43-50.
CR  - Youssef D, Shams W, Bailey B ve ark. Effective strategy for decreasing blood culture contamination rates: the experience of a veterans affairs medical centre. Journal of Hospital Infection 2012;81:288-291.
CR  - Zarbo RJ, Jones BA, Friedberg RC ve ark. Q-tracks: a College of American Pathologists program of continuous laboratory monitoring and longitudinal tracking. Archives of Pathology& Laboratory Medicine 2002;126:1036-1044.
UR  - http://dergipark.org.tr/tr/pub/egehemsire/issue//292529
L1  - http://dergipark.org.tr/tr/download/article-file/383430
ER  -