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Abstract Routine blood culture is used for the detection of bloodstream infections by aerobic and anaerobic bacteria and by common pathogenic yeasts. A retrospective study was conducted in a public hospital in Maceió-AL, by collecting data of all medical records with positive blood cultures. Out of the 2,107 blood cultures performed, 17% were positive with Staphylococcus coagulase negative (51.14%), followed by Staphylococcus aureus (11.21%) and Klebsiella pneumoniae (6.32%). Gram-positive bacteria predominated among positive blood cultures, highlighting the group of Staphylococcus coagulase-negative. While Gram-negative bacteria had a higher number of species among positive blood cultures.
Resumo A cultura sanguínea de rotina é usada para a detecção de infecções na corrente sanguínea por bactérias aeróbias e anaeróbias e por leveduras patogênicas comuns. Estudo retrospectivo realizado em hospital público de Maceió-AL, por meio da coleta de dados de todos os prontuários com culturas sanguíneas positivas. Das 2.107 culturas sanguíneas realizadas, 17% foram positivas com Staphylococcus coagulase negativo (51,14%), seguido por Staphylococcus aureus (11,21%) e Klebsiella pneumoniae (6,32%). As bactérias Gram-positiva predominaram entre as culturas de sangue positivas, destacando-se o grupo das Staphylococcus coagulase-negativo. Enquanto as bactérias Gram-negativas apresentaram um número maior de espécies entre as culturas de sangue positivas.
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Abstract Routine blood culture is used for the detection of bloodstream infections by aerobic and anaerobic bacteria and by common pathogenic yeasts. A retrospective study was conducted in a public hospital in Maceió-AL, by collecting data of all medical records with positive blood cultures. Out of the 2,107 blood cultures performed, 17% were positive with Staphylococcus coagulase negative (51.14%), followed by Staphylococcus aureus (11.21%) and Klebsiella pneumoniae (6.32%). Gram-positive bacteria predominated among positive blood cultures, highlighting the group of Staphylococcus coagulase-negative. While Gram-negative bacteria had a higher number of species among positive blood cultures.
Resumo A cultura sanguínea de rotina é usada para a detecção de infecções na corrente sanguínea por bactérias aeróbias e anaeróbias e por leveduras patogênicas comuns. Estudo retrospectivo realizado em hospital público de Maceió-AL, por meio da coleta de dados de todos os prontuários com culturas sanguíneas positivas. Das 2.107 culturas sanguíneas realizadas, 17% foram positivas com Staphylococcus coagulase negativo (51,14%), seguido por Staphylococcus aureus (11,21%) e Klebsiella pneumoniae (6,32%). As bactérias Gram-positiva predominaram entre as culturas de sangue positivas, destacando-se o grupo das Staphylococcus coagulase-negativo. Enquanto as bactérias Gram-negativas apresentaram um número maior de espécies entre as culturas de sangue positivas.
Assuntos
Humanos , Sepse , Bactérias Gram-Negativas , Brasil , Estudos Retrospectivos , HospitaisRESUMO
Objective To investigate the death prognosis and risk factors of extensively drug-resistant Acinetobacter baumannii in hospitalized elderly patients with hematological infection, so as to facilitate clinical prevention and treatment. Methods The elderly (> 80 years old) hospitalized patients with hematological infection in our hospital from 2015 to 2021 were selected for analysis. Firstly, 314 patients with extensively drug-resistant Acinetobacter baumannii hematological infection were distinguished by etiological analysis. A total of 98 cases of death were detected during hospitalization (later referred to as the observation group). By comparing with the surviving patients (216 cases) (later referred to as the control group), the general data of patients with XDRAB infection were collected, and the risk of death and its influencing factors were analyzed. Results In the study, the proportion of patients in the observation group who used catheters was higher, the catheter retention time was longer, the acute physiology and chronic health status II scores were higher, and the proportion of patients who lost self-care ability was also higher. Conclusion The death of blood borne infection of extensively drug-resistant Acinetobacter baumannii in elderly patients is affected by many factors. Among them, patients who use catheters for a long time, have poor self-care ability and lose self-care ability have a higher risk of death, which is worthy of clinical attention.
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Objective To investigate the diagnostic values of procalcitonin (PCT),high sensitive C-reactive protein (hs-CRP),white blood cell (WBC)and percentage of neutrocyte (NEU％)in Gramnegative and Gram-positive bacterial blood stream infection in early stage of sepsis in order to investigate the correlation between PCT and APACHE lⅡ score as well as between PCT and SOFA score,and the prognostic value in assessment of Gram-negative and Gram-positive bacterial blood stream infection.Methods Clinical data of patients admitted to ICU from January 2012 through December 2014 were retrospectively analyzed.A total of 124 sepsis patients with blood stream infection were checked with PCT,hs-CRP,WBC and NEU％ tests,and APACHE Ⅱ score and SOFA score were calculated.The differences in APACHE Ⅱ score and SOFA score were compared between Gram-negative group (n =41) and Gram-positive group (n =83).The correlation between PCT and APACHE Ⅱ score as well as between PCT and SOFA score was analyzed.The differences in diagnostic values of PCT,hs-CRP,WBC and NEU％ between Gram-negative group and Grampositive group were analyzed by using receiver operating characteristic (ROC) curve and it was plotted to assess the prognostic values of PCT,hs-CRP,WBC and NEU％ for septic patients with blood stream infection.Results Compared with Gram-positive group,the levels of PCT [.55.32 (22.01,97.11) vs.2.13 (0.27,5.27)] (P ＜0.01),hs-CRP [105.09 (69.97,186.12) vs.70.54 (42.37,138.63)] (P=0.508),NEU％ [88.30 (75.79,93.52) vs.55.32 (22.01,97.11)] (P=0.302) were higher but WBC was lower [13.59 (10.74,17.58) vs.13.73 (11.32,20.90)] (P=0.058) in Gram-negative group.The ROC curve analysis of PCT showed the area under the curve (AUC) was 0.867 (95％ CI:0.789-0.946).When the optimal cutoff point of PCT was 17.48 ng/mL,the largest Youden's index was found to be 0.661 with 76.9％ sensitivity and 89.2％ specificity.Between two groups,there were significant differences in APACHE Ⅱ score and SOFA score (27.46 ± 9.60 vs.23.67 ± 7.74,P =0.020;8.05 ±3.38 vs.6.59-±3.45,P =0.028).There was significant difference in diagnostic value between PCT and SOFA (r =0.536,P =0.036) in Gram-negative group but no significant difference in Gram-positive group.Conclusions Higher PCT levels are found in Gram-negative group and it can play a role in differntiation between the Gram-negative group and Gram-positive group rather than hs-CRP,WBC and NEU％.PCT can be a better indicator for evaluation of severity of sepsis as well as for prognosis of sepsis patients with Gram-negative bacterium infection.
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Objective To investigate the clinical effect of ulinastatin treating systemic inflammatory response in the patients with serious blood infection .Methods The patients with serious blood infection in our hospital were selected and divided into the control group and observation group .The control group was treated with the conventional treatment ,while on this basis the observation group was added with ulinastatin .The body temperature ,heart rate ,respiratory rate ,WBC ,Scr ,CRP ,PCT ,TNF-α,APACHE Ⅱscore and mortality rate were compared between the two groups .Results The body temperature ,heart rate ,respiratory rate and A-PACHE Ⅱ score in the observation group were lower than those in the control group ,moreover ,the levels of WBC ,CRP ,PCT , TNF-αand Scr ,and mortality rate in the observation group were lower than those in the control group ,the differences were statisti-cally significant (P<0 .05) .Conclusion Uinastatin has good effect for treating systemic inflammatory response in the patients with serious blood infection ,which can decrease the mortality and is worth clinical promotion .
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Objective To analyze the high risk factors of blood infection in Chinese citizens' organ donation,provide the basic evidence for early protection,increase the success rate of donor distribution,and expand the Chinese organ donation pool.Methods A retrospective study was performed on 70 cases of donation recruited during October 2014 to January 2016.The incidence of blood infection in these donors was analyzed.The univariate analysis and multivariate logistic regression analysis were used to find out the high risk factors influencing the donor blood infection.Finally,the donor blood infection assessment model and the receiver operating characteristic (ROC) curve were established to assess the sensitivity and specificity.Results The overall infection rate was 64.3％ (45/70).The pulmonary,blood,and urinary tract infection rate was 42.9％,31.4％ and 1.4％ respectively.The total length of hospital stay (＞10 days) (P =0.017),oxygenation index (＜ 233.5 ± 107.0) (P =0.046),aspartate aminotransferase (＞196.9 ± 329.1 U/L) (P =0.044),and valley alanine aminotransferase (＞95.0 ± 78.1 U/L) (P =0.026) were four risk factors for predicting the donor blood infection.The multivariate logistic regression analysis revealed that the total length of stay ＞10 days along with the donors' oxygenation index (＜233.5 ± 107.0) was independent risk factor for predicting the blood infection.The donor blood infection model was:0.193 + 1.753 hospital stay (＞10 days)-0.007 oxygenation index.The sensitivity and specificity were 0.682 and 0.75 (P ＜0.001) respectively.Conclusion For a long-term stay in ICU,the rate of blood infection for donors was much higher,at this time,the most effective antibiotics should be chosen.Besides,improving donor oxygenation index and liver function can reduce the incidence of infection.
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Objective To analyze the pathogen distribution and drug resistance of candida isolated from children with blood infections in our hospital,and to provide reference for clinical effective prevention and treatment.Methods The blood specimens of pediatric patients were collected between January 2009 and December 2015,and were cultured using BacT/ALERT 3D and BD9140 instruments.The candida were separated with Sobaurandps agar culture medium,and identified with chromogenic medium,API 20CAUX test strips or VITEK-2 compact YST card.The minimal inhibitory concentration of 5 drugs were determined by ATB FUNGUS 3 system.Results In 176 cases,92 strains (52.3％) were from neonatal ward,and 46 strains (26.1％) were from PICU.In newborn group,85 strains were isolated from premature,which contained the low and very low birth weight infants (37 strains),pneumonia(20 strains),neonatal respiratory distress syndrome(9 strains).In PICU,the strains were commonly isolated from children with severe infection.Among 176 strains of candida,71 strains (40.3％) were C.albicans,62 strains (35.2％) were C.parapsilosis,16 strains(9.1％) were C.glabrata,9 strains(5.1％) were C.tropicalis,and 18 strains(10.2％) belonged to other candida.Conclusion Candida blood infections can happen at all age of chlidren.The most common strains detected from blood were C.albicans,followed by C.parapsilosis.Most of these strains are susceptible to antifungal drugs,such as fluconazole,except C.glabrata.The sensitive rates to commonly used antifungal drug are more than 93％.The selection of antifungal drugs should be based on the species of strains.
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Objective To understand the pathogenic distribution and drug resistance in the patients with blood infections in our hospital to provide reference for the empirical medication of blood infections .Methods The cases of blood infections in our hospital during the period 2012-2014 were performed the retrospective investigation .The BD Bactec blood culture system was adopted to conduct the blood culture .The bacterial strain identification and susceptibility test was conducted by using the Microscan Walkaway 40 and the data were analyzed by adopting the WHONET5 .6 software .Results The top four of department distribution in blood infections were the digestive system department ,lung diseases department ,orthopedic department and surgery department ,account‐ing for 25 .20% ,19 .60% ,14 .70% and 10 .50% respectively .The pathogens were mainly Gram negative bacteria ,and the top three were Escherichia coli ,Klebsiella pneumoniae and non fermenting bacteria ,accounting for 44 .10% ,13 .30% and 7 .69% respective‐ly .The top three of Gram positive bacteria were coagulase negative staphylococci ,Staphylococcus aureus and Enterococcus ,account‐ing for 12 .58% ,9 .09% and 7 .69% respectively .The positive rates of ESBL in Escherichia coli and Klebsiella pneumoniae were 45 .5% and 60 .8% respectively .The detection rate of methicillin resistant coagulase negative staphylococci (MRCNS) was 55 .5% , which of methicillin-resistant staphylococcus aureus (MRSA) was 58 .0% .Conclusion The cases of blood infections in our hospi‐tal come from different wards areas ,and the digestive system department is in the majority mostly .The pathogenic bacteria are dom‐inated by Gram negative bacteria ,and the treatment should rationally use the antibacterial drugs according to the bacteria drug re‐sistance situation .
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Objective To study the cognitive behaviors of ICU nurses about cluster intervention strategies of central venous catheter blood infection.Methods Two hundred and two ICU nurses were involved in the survey using self-designed questionnaire.Results The scores on knowledge of ICU nurses with cluster intervention strategies was(31.9±2.8)and the score on the cognitive behaviors was(26.9±2.6). Conclusions The ICU nurses’knowledge on cluster intervention strategies is at a general level and their behaviors are at the status ofseldomorsometimes.Therefore,improvement of manipulation flowsheet,control of routes for bacterial infections and enhancement of knowledge learning are critical for the improvement of cognitive behaviors of ICU nurses with cluster intervention strategies.
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Objective To study the clinical characteristic and antifungal drug sensitivity of neonatal Candida parapsilosis infections in blood and to provide reference for clinical prevention and therapy.Methods The drug resistance of Candida parapsilosis which were isolated from 8 neonatal blood specimen on the laboratory were analyzed and clinical characteristic of infections in neonates were investigated retrospectively.The blood cultured with BD9120.The fungi were isolated with Sabourand Dextrose Agar and CHROMagar colored medium and identified with API20C.The susceptibility test was then performed with FUNGUS3 micro dilution plate.Results Candida parapsilosis susceptibility results to antifungal drugs showed that 5-flucytosine≤ 4 μg/ml,amphotericin B ≤ 0.5 μg/ml,fluconazole ≤ 1 ～ 2.0 μg/ml,itraconazole ≤ 0.125 ～0.125 μg/ml,voriconazole ≤0.06 ～0.06 μg/ml.Seven cases were preterm infants(low birth weight infants or extremely low birth weight infants),one case was term infant after operation of congenital pyloric atresia.Before blood culture,all the 8 cases of Candida parapsilosis sepsis had received broad-spectrum antibiotics and intravenous nutrition.All the 8 cases had received peripherally inserted central catheter,and 3 cases had received mechanical ventilation.Four cases with fluconazole,3 cases with fluconazole and amphotericin B,1 case with fluconazole at the onset but changed VFend,all 8 cases were cured.Conclusion Candida parapsilosis has become the one of the main pathogens of neonatal infection fungal in blood of premature or low birth weight infants,which is sensitive to 5 kinds of antifungal drugs in vitro susceptibility test.Early detection and antifungal therapy can improve the prognosis.
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Objective To investigate the drug resistance of patients samples in terms of pathogenic bacteria in order to provide the basis for clinical diagnosis,treatment of blood infection.Methods Six hundred and seventy-one bacteria strains out of 5042 blood samples of hospitalized patients were used to analyze its characters and drug resistance from January 2009 to December 2012 in the people's hospital of inner mongolia autonomous region.BacT AIERT 3D automatic rapid microbial detection system was applied to perform blood culture.The bacteria identification and drug sensitivity test (MIC method) were detected by using VITEK 2Compact automatic bacteria identification instrument.Results Bacteria positive rate was 13.3％ (671/5042),of which the gram negative bacilli accounted for 49.9％ (335/671),and gram positive for 40.8％ (274/671).The top 5 bacteria strains of blood samples were escherichia coli,staphylococcus,staphylococcus aureus,klebsiella pneumoniae and staphylococcus aureus.The pathogenic bacteria rates of blood samples were 30.5％(29/95),44.4％ (55/124) and 52.5％ (94/179) respectively during 2009-2012.The main source of blood bacteria renal were department of internal medicine ward (12.1％,81/671),department of general surgery (11.6％,78/671),and ICU ward (10.6％,71/671).The detected bacteria rate in department of general surgery separation rate increased to the first in 2012 from fifth in 2009.However the detected bacteria rate in department of internal medicine was down to the tenth in 2012 from the third in 2009.The drug resistance rate of imipenem,piperacillin/tazobactam,cefotaxime,ceftazidime resistant cefotetan on escherichia coli and klebsiella pneumoniae were all less than 9.7％,and the rate of linezolid,vancomycin,teicoplanin,quinupristin/dafoe leptin and nitrofurantoin resistance of staphylococcus aureus,staphylococcus bacteria and gold staphylococcus aureus were all less than 2.3％.Conclusion The distribution,sources and drug resistance of pathogenic bacteria had been changed recently.Therefore the laboratory shall strengthen the monitoring of drug resistance of bacteria in the bloodstream infection in order to guide clinical rational application of antibiotics.
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OBJECTIVE To study the distribution of drug-resistant gene of meticillin-resistant coagulase negative Staphylococcus(MRCNS) in children septicemia.METHODS The total MRCNS isolates were 40,and whether in there harbored genes mec,erm and qac was studied.RESULTS Among 40 CNS strains,in there harbored genes mec,erm,and qac were 38(95.0%),30(75.0%) and 18(45.0%),respectively.CONCLUSIONS MRCNS in children septicemia where harbor drug resistance genes is very serious,so we should pay great heed to its effective control.
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OBJECTIVE To investigate the significance of the blood infection marker detection in pregnant women before delivery.METHODS From Jan to Oct 2007,a total of 2010 cases pregnant women were tested the HBsAg,HCV antibody,HIV1/2 antibody and RPR.RESULTS From them HBsAg was positive in 185 cases,the positive rate was 9.2%;4 cases was with positive HCV antibody,the positive rate was 0.2%;HIV1/2 antibody was not tested out;10 cases was with positive RPR antibody,the positive rate was 0.5%.The total positive rate was 9.9%.CONCLUSIONS The prenatal infection rates of hepatitis B,hepatitis C and RPR in the pregnant women show high rates which show the possible vertical transmission.It is essential to test infection marker in the pregnant women and,take effective measures.