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Kan Kültüründe Kalite Güvence Göstergelerinin ve Kontaminasyon Oranının Değerlendirilmesi

Yıl 2021, Cilt: 13 Sayı: 3, 557 - 562, 18.10.2021
https://doi.org/10.18521/ktd.858764

Öz

Amaç: Kan kültürü, sepsise neden olan mikroorganizmaların üretilmesini ve tanımlanmasını sağladığı, antibiyotik tedavisini zamanında başlamayı ve mortalite ve morbiditeyi azalttığı için hasta takibinde hayati öneme sahiptir. Bu çalışmada hastanemiz mikrobiyoloji laboratuvarında otomatik kan kültür sisteminde üretilen mikroorganizmaların kalite göstergeleri açısından değerlendirilmesi amaçlanmıştır.
Metod: Bu çalışmada, XXX Üniversitesi Tıbbi Mikrobiyoloji Laboratuvarına gönderilen kan kültürü örneklerinden otomatize kan kültürü BACTEC-9120 (Becton Dickinson, ABD) sisteminde üreyen mikroorganizmalar retrospektif değerlendirilmiştir. Bu amaçla kan kültürü istemi yapılan örneklerin reddedilme ve kontaminasyon oranı, Gram boyama sonucu-son identifikasyon uyum oranı, tek şişe gönderilen örnek sayısı ve inkübasyon sonrası mikroorganizmaların üreme süreleri belirlenmiştir.
Bulgular: Laboratuvara çeşitli kliniklerden gönderilen 5037 kan kültür örneği dahil edilmiştir. Bu örneklerden %1.7’si uygunsuz numune olarak reddedilmiştir. Gram boyama -son identifikasyon uyumu araştırılmış ve %97,8 olarak saptanmıştır. Gönderilen örneklerin tek şişe sayısı 511 olarak bulunmuştur. Çalışmaya alınan 5037 örneğin, %20.7’sinde üreme saptanmış, bunların %10.2’si kontaminant olarak kabul edilmiştir. Araştırmamızda üreme süresi incelenen etkenlerin ortalama üreme süresi 30,29 saat olarak saptanmıştır.
Sonuç: Sonuç olarak, kan kültürlerinde gerçek patojenleri kontaminant ajanlardan ayırt etmek için altın standart yoktur.

Kaynakça

  • 1. Pan F, Zhao W, Zhang H. Value of time to positivity of blood culture in children with bloodstream infections. Can J Infect Dis Med Microbiol. 2019(1):1-6.
  • 2.Lamy B, Dargere S, Aredrup MC, Parienti JJ, Tattevin P. How to optimize the use of blood cultures for the diagnosis of blood stream infections? A state of the art. Front Microbiol. 2016; 7: 697.
  • 3.Balıkçı A, Belas Z, Topkaya AE. Blood culture positivity: is it pathogen or contaminant? Mikrobiyol Bul. 2013;47(1):135–40.
  • 4.Hopkins K, Huynh S, McNary C, Walker A, Nixon R, Craighead JE. Reducing blood culture contamination rates: a systematic approach to improving quality of care. Am J Infect Control. 2013;41(12):1272–74.
  • 5.Ombelet S, Barbé1 B, Affolabi D, Ronat JB, Lompo P, Lunguya O, et al. Best practices of blood cultures in low- and middle-income countries front. Front Med. 2019; 6: 131.
  • 6.Sogaard M, Norgaard M, Schonheyder HC. First notification of positive blood cultures and the high accuracy of the gram stain report. J Clin Microbiol. 2007;45(4):1113–7.
  • 7.Dempsey C, Skoglund E, Muldrew KL, Garey KW. Economic health care costs of blood culture contamination: a systematic review. Am J Infect Control. 2019;47(8):963–67.
  • 8.Garcia RA, Spitzer ED, Beaudry J, Beck C, Diblasi R, Gilleeny-Blabac M, et al. Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central linee associated bloodstream infections. Am J Infect Control. 2015;43(11):1222-37.
  • 9.Klinik Örnekten Sonuç Raporuna Uygulama Rehberi [Internet].Ankara: Çağhan Ofset Matbaacılık; 2017 [cited 2019 Jun 23]. Available from: https://www.klimud.org/public/uploads/content/files/Kan%20Dola%C5%9F%C4%B1m%C4%B1%20%C3%B6rnekleri.pdf
  • 10.Hughes A, Cabilan CJ, Williams J, Ray M, Coyer F. The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol. Syst Rev. 2018;7(1):216.
  • 11.Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev. 2006;19(4):788–802.
  • 12.Dawson S. Blood culture contaminants. J Hosp Infect. 2014;87(1):1–10.
  • 13.Ramli SR, Zahari S, Sadri A, Aziz ZF, Francis A. Reducing blood culture contamination rate: a quality assurance project in a Malaysian tertiary hospital. Int J Infect Control. 2014;10(2).
  • 14.Veranyurt Ü, Ertürk A, Veranyurt O, Akalın B. Contamination rates of blood culture samples. Journal of Current Researches on Health Sector. 2018;8(2):365–70.
  • 15.Durmaz G, Us T, Aydinli A, Kiremitci A, Kiraz N, Akgun Y. 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(2):819–21.
  • 16.Dierig A, Berger C, Agyeman PKA, Bernhard-Stirnemann S, Giannoni E, Stocker M, et al. Time-to-positivity of blood cultures in children with sepsis. Front Pediatr. 2018;6:222.
  • 17.Friedman ND, Braun T, Fallach N, Carmeli Y. Blood culture sampling practices among internal medicine inpatients. Clin Microbiol Infect Dis. 2017;2(1):1–6.

Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture

Yıl 2021, Cilt: 13 Sayı: 3, 557 - 562, 18.10.2021
https://doi.org/10.18521/ktd.858764

Öz

Objective: Blood culture are of vital importance in patient follow-up, as they enable the identification and production of sepsis causative microorganisms, initiate antibiotic treatment in a timely manner and reduce mortality and morbidity. In this study, it is aimed to evaluate the microorganisms grown in the automated blood culture in the microbiology laboratory of the hospital in terms of quality indicators.
Method: In this study, microorganisms grown from automated blood culture BACTEC-9120 (Becton Dickinson, USA) system from the blood culture samples sent to XXX University Medical Microbiology Laboratory were evaluated retrospectively. For this purpose, the rejection and contamination rate of the samples for which blood culture was requested, the result of Gram staining-final identification compliance, the number of samples sent from a single bottle, and the growth times of microorganisms after incubation were determined.
Result: 5037 blood culture samples were sent to the laboratory from various clinics. 1.7% of these samples were rejected as inappropriate samples. Gram stain-final identification compatibility of blood cultures was investigated and it was determined as 97.8%. The single bottle number of the samples sent was found to be 511. For the 5037 samples included in the study, growth was detected in 20.7%, of which 10.2% were considered as contaminants. In our study, the average breeding time of the factors examined for breeding time was determined to be 30.29 hours.
Conclusion: As conclusion, there is no gold standard to distinguish true pathogens from contaminant agents in blood cultures.

Kaynakça

  • 1. Pan F, Zhao W, Zhang H. Value of time to positivity of blood culture in children with bloodstream infections. Can J Infect Dis Med Microbiol. 2019(1):1-6.
  • 2.Lamy B, Dargere S, Aredrup MC, Parienti JJ, Tattevin P. How to optimize the use of blood cultures for the diagnosis of blood stream infections? A state of the art. Front Microbiol. 2016; 7: 697.
  • 3.Balıkçı A, Belas Z, Topkaya AE. Blood culture positivity: is it pathogen or contaminant? Mikrobiyol Bul. 2013;47(1):135–40.
  • 4.Hopkins K, Huynh S, McNary C, Walker A, Nixon R, Craighead JE. Reducing blood culture contamination rates: a systematic approach to improving quality of care. Am J Infect Control. 2013;41(12):1272–74.
  • 5.Ombelet S, Barbé1 B, Affolabi D, Ronat JB, Lompo P, Lunguya O, et al. Best practices of blood cultures in low- and middle-income countries front. Front Med. 2019; 6: 131.
  • 6.Sogaard M, Norgaard M, Schonheyder HC. First notification of positive blood cultures and the high accuracy of the gram stain report. J Clin Microbiol. 2007;45(4):1113–7.
  • 7.Dempsey C, Skoglund E, Muldrew KL, Garey KW. Economic health care costs of blood culture contamination: a systematic review. Am J Infect Control. 2019;47(8):963–67.
  • 8.Garcia RA, Spitzer ED, Beaudry J, Beck C, Diblasi R, Gilleeny-Blabac M, et al. Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central linee associated bloodstream infections. Am J Infect Control. 2015;43(11):1222-37.
  • 9.Klinik Örnekten Sonuç Raporuna Uygulama Rehberi [Internet].Ankara: Çağhan Ofset Matbaacılık; 2017 [cited 2019 Jun 23]. Available from: https://www.klimud.org/public/uploads/content/files/Kan%20Dola%C5%9F%C4%B1m%C4%B1%20%C3%B6rnekleri.pdf
  • 10.Hughes A, Cabilan CJ, Williams J, Ray M, Coyer F. The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol. Syst Rev. 2018;7(1):216.
  • 11.Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev. 2006;19(4):788–802.
  • 12.Dawson S. Blood culture contaminants. J Hosp Infect. 2014;87(1):1–10.
  • 13.Ramli SR, Zahari S, Sadri A, Aziz ZF, Francis A. Reducing blood culture contamination rate: a quality assurance project in a Malaysian tertiary hospital. Int J Infect Control. 2014;10(2).
  • 14.Veranyurt Ü, Ertürk A, Veranyurt O, Akalın B. Contamination rates of blood culture samples. Journal of Current Researches on Health Sector. 2018;8(2):365–70.
  • 15.Durmaz G, Us T, Aydinli A, Kiremitci A, Kiraz N, Akgun Y. 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(2):819–21.
  • 16.Dierig A, Berger C, Agyeman PKA, Bernhard-Stirnemann S, Giannoni E, Stocker M, et al. Time-to-positivity of blood cultures in children with sepsis. Front Pediatr. 2018;6:222.
  • 17.Friedman ND, Braun T, Fallach N, Carmeli Y. Blood culture sampling practices among internal medicine inpatients. Clin Microbiol Infect Dis. 2017;2(1):1–6.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Şükrü Öksüz 0000-0002-4893-5564

Betül Dönmez 0000-0003-1790-7621

Banu Keskin 0000-0002-2102-3952

Nagihan Memiş 0000-0001-6980-9244

Zeynep Dilara Karamurat 0000-0001-5033-1527

Emel Çalışkan 0000-0002-9451-7865

Cihadiye Öztürk 0000-0002-4330-2864

İdris Şahin 0000-0001-6203-5039

Yayımlanma Tarihi 18 Ekim 2021
Kabul Tarihi 3 Eylül 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 13 Sayı: 3

Kaynak Göster

APA Öksüz, Ş., Dönmez, B., Keskin, B., Memiş, N., vd. (2021). Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture. Konuralp Medical Journal, 13(3), 557-562. https://doi.org/10.18521/ktd.858764
AMA Öksüz Ş, Dönmez B, Keskin B, Memiş N, Karamurat ZD, Çalışkan E, Öztürk C, Şahin İ. Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture. Konuralp Medical Journal. Ekim 2021;13(3):557-562. doi:10.18521/ktd.858764
Chicago Öksüz, Şükrü, Betül Dönmez, Banu Keskin, Nagihan Memiş, Zeynep Dilara Karamurat, Emel Çalışkan, Cihadiye Öztürk, ve İdris Şahin. “Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture”. Konuralp Medical Journal 13, sy. 3 (Ekim 2021): 557-62. https://doi.org/10.18521/ktd.858764.
EndNote Öksüz Ş, Dönmez B, Keskin B, Memiş N, Karamurat ZD, Çalışkan E, Öztürk C, Şahin İ (01 Ekim 2021) Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture. Konuralp Medical Journal 13 3 557–562.
IEEE Ş. Öksüz, B. Dönmez, B. Keskin, N. Memiş, Z. D. Karamurat, E. Çalışkan, C. Öztürk, ve İ. Şahin, “Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture”, Konuralp Medical Journal, c. 13, sy. 3, ss. 557–562, 2021, doi: 10.18521/ktd.858764.
ISNAD Öksüz, Şükrü vd. “Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture”. Konuralp Medical Journal 13/3 (Ekim 2021), 557-562. https://doi.org/10.18521/ktd.858764.
JAMA Öksüz Ş, Dönmez B, Keskin B, Memiş N, Karamurat ZD, Çalışkan E, Öztürk C, Şahin İ. Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture. Konuralp Medical Journal. 2021;13:557–562.
MLA Öksüz, Şükrü vd. “Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture”. Konuralp Medical Journal, c. 13, sy. 3, 2021, ss. 557-62, doi:10.18521/ktd.858764.
Vancouver Öksüz Ş, Dönmez B, Keskin B, Memiş N, Karamurat ZD, Çalışkan E, Öztürk C, Şahin İ. Evaluation of Quality Assurance Indicators and Contamination Rate in Blood Culture. Konuralp Medical Journal. 2021;13(3):557-62.