Çocuk Acil Servisinde Kan Kültürü Kullanımı

Objective: Fever is a significant presenting complaint in pediatric emergency services. Blood stream infections have high morbidity and mortality rates, especially in young children and newborns. Blood cultures are the gold standard to determine the agent. Although there are many studies on hospitalized patients, no published data are available on the utility of blood cultures in a pediatric emergency department from our country. We conducted this study to evaluate the distribution of microorganisms isolated from blood cultures sent from a university pediatric emergency department and to evaluate the usage of blood cultures and antibiotic choice. Material and Methods: This retrospective study included 10642 blood cultures that were sent to the Clinical Microbiology Laboratory of Ankara University Faculty of Medicine between January 2011 and December 2012 by the Pediatric Emergency Department of the same university. Results: During the study period, 10642 blood cultures were evaluated at the Clinical Microbiology Laboratory. There was no growth in 10018 (94.2%) samples and 585 (93.7%) samples were considered to be contaminated. Various bacteria were determined in 624 (5.8%) samples; 91.7% (n=573) were Gram positive and 8.3% (n=51) were Gram negative. 58.2% (n=363) of the isolated microorganism consisted of coagulase-negative staphylococci and 19.8% (n=72) were resistant to methicillin. S. pneumonia (n= 11), S. aureus (n=10) and Enterococcus (n=7) were also isolated from blood cultures. Glucopeptide resistance was not found in the Staphylococcus and Enterococcus isolates. E. coli was isolated in three samples and ESBL were positive in two of these strains. Conclusion: Distribution and antimicrobial susceptibility of microorganisms isolated from blood cultures may vary in time. Each center should monitor their data in order to organize empirical treatment. Samples should be obtained following the rules of asepsis to identify the pathogens in blood culture. Unnecessary spending of limited resources should be avoided by reducing the contamination rates.