Prospective evaluation of blood cultures in a Turkish university hospital: epidemiology, microbiology and patient outcome

Clin Microbiol Infect. 2003 Oct;9(10):1038-44. doi: 10.1046/j.1469-0691.2003.00714.x.

Abstract

The aims of this prospective study were to: (1) determine the rate of blood culture contamination; (2) describe and compare the epidemiologic, clinical and microbiological characteristics of hospital- and community-acquired bloodstream infections; and (3) determine the mortality resulting from bloodstream infections. The rate of true bacteremia was 12.1%, and 10.7% of cultures were contaminated. Of the 567 episodes of bloodstream infection, 73.4% were hospital-acquired, and 26.6% were community-acquired. The most commonly isolated microorganisms were staphylococci (44%, methicillin resistant 69.4%), enterococci (15%) and Escherichia coli (12.5%) in hospital-acquired episodes, and Brucella spp. (21.9%), E. coli (19.2%) and Staphylococcus aureus (14.6%, methicillin resistant 9.1%) in community-acquired episodes. While the overall mortality rate was 25.4%, death attributable to bloodstream infections was 16.6% in hospital-acquired episodes and 13.9% in community-acquired episodes. The highest mortality occurred in patients with bacteremia due to Pseudomonas aeruginosa (37.5%) in hospital-acquired episodes, and in patients with bacteremia due to Streptococcus pneumoniae (50%) in community-acquired episodes. Underlying diseases, severity of illness, presence of bladder catheter, previous use of antibiotics, tracheal intubation and adequacy of treatment were found to be significantly associated with death.

MeSH terms

  • Bacteremia / blood
  • Bacteremia / epidemiology
  • Bacteremia / microbiology*
  • Bacteremia / mortality
  • Blood / microbiology*
  • Brucellosis / blood
  • Brucellosis / epidemiology
  • Brucellosis / microbiology
  • Brucellosis / mortality
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology*
  • Community-Acquired Infections / mortality
  • Cross Infection / blood
  • Cross Infection / epidemiology
  • Cross Infection / microbiology*
  • Cross Infection / mortality
  • Escherichia coli Infections / blood
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Escherichia coli Infections / mortality
  • Hospital Mortality
  • Humans
  • Incidence
  • Prospective Studies
  • Staphylococcal Infections / blood
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / mortality
  • Turkey / epidemiology