Author/Editor		Pokrajac, T; Gubina, M; Derganc, M; Dragaš, AZ; Mueller-Premru, M; Muzlovič, I; Vidmar, I; Lazar, I; Kalan, G
Title		Ocena metode kvantitativnih hemokultur in njen pomen za diagnozo katetrske sepse
Translated title		The evaluation of a method of the quantitative blood culture in the diagnosis of the catheter related sepsis
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. Suppl 3
Publication year		1995
Volume		str. III-59-64
Language		slo
Abstract		Background. Sepsis is an important cause of death in the critically ill treated in Intensive Care Units. The early and accurate diagnosis of septic patients is of key importance to their survival. The most often source of sepsis, particularly in newborns, are intravascular catheters. Than we are talking about catheter related sepsis. The quantitative blood culture method are the most important method for the diagnosis of sepsis, particularly in catheter-related sepsis. The aim of the study was to evaluate importance of a method of quantitative blood cultures in the diagnosis of sepsis in critically ill newborns, children and adults, and particularly in the diagnosis of catheter-related sepsis. We established its significance in estimating the prognosis of sepsis. Patients and methods. In the period of two years we examined 86 patients treated in units for the intensive therapy of adults and children at the Clinic for Infectious Diseases and Febrile States, at the Pediatric Intensive Care Unit and at the Clinic for Plastic Surgery and Burns at the Clinic Centre of Ljubljana. Number of bacteria was justified in 1 ml patient's blood volume using quantitative blood culture technique. Results. In 31 patients we proved sepsis by a method of quantitative blood culture, while in 55 patients the blood culture remained negative despite clinical indicators of sepsis. Of the 31 patients with a positive blood culture, we found catheter related sepsis in 6 patients and established according to the definition of catheter related sepsis that only 4 of these six patients had tipical cathete r-related sepsis. Of all parametra of the septic state that we compared, only 8 (alteration of mental state in the sense of letargy, fatigue, chills, hypotension, glucosuria, metabolic acidosis, a diminished level of inorganic phosphate in the serum and elevated level of C-reaktive protein) had a positive ratio with the number of bacteria in one millilitre of the patient's blood.(trunc.)
Summary		Izhodišča. Sepsa je najpogostejši vzrok smrti pri bolnikih, ki se zdravijo v enotah za intenzivno terapijo, zato je zgodnja in natančna diagnostika sepse zelo pomembna za preživetje teh bolnikov. Zelo pogosto je izvor sepse okužen i.v. kateter, posebno pri novorojenčkih. Takrat govorimo o katetrski sepsi. Za potrditev sepse in zlasti katetrske sepse je metoda kvantitativnih hemokultur najpomembnejša laboratorijska preiskava. Namen raziskave je bil ovrednotiti metode kvantitativnih hemokultur v diagnostiki sepse pri novorojenčkih, otrocih in odraslih, zlasti pa v diagnostiki katetrskih seps. Ugotavljali smo tudi pomen metode kvantitativnih hemokultur pri prognozi sepse. Bolniki in metode. V obdobju dveh let smo pregledali 86 bolnikov, ki so se zdravili v enotah za intenzivno zdravljenje odraslih in otrok na Kliniki za infekcijske bolezni in vročinska stanja, na pediatričnem oddelku kirurških strok in na Kliniki za plastično kirurgijo in opekline v Kliničnem centru v Ljubljani. Z metodo kvantitativnih hemokultur smo določili število v 1ml bolnikove krvi. Rezultati. Pri 31 bolnikih smo z metodo kvantitativnih hemokultur dokazali sepso, a pri 55 bolnikih je kljub kliničnim znakom sepse hemokultura ostala negativna. Od 31 bolnikov s pozitivno hemokulturo smo pri šestih bolnikih sklepali na katetrsko sepso in glede na definicijo katetrskih seps ugotovili, da imajo le štirje bolniki katetrsko sepso. Od 11 kazalnikov septičnega stanja, ki smo jih primerjali, glukozurija, metabolna acidoza, zmanjšane vrednosti anorganskega fosfata v serumu in povečane vrednosti C-reaktivnega protein a) v pozitivnem razmerju s številom bakterij v mililitru bolnikove krvi. Zaključki. Ugotovili smo, da metoda kvantitativnih hemokultur omogoča zanesljivo diagnostiko katetrske sepse. Metoda je tudi pomembna za prognozo sepse pri kritično bolnih. Dokazali smo, da navzočnost antibiotika v krvi zmanjša število bakterij v mililitru bolnikove krvi.
Descriptors		INTENSIVE CARE UNITS CATHETERIZATION SEPSIS COLONY COUNT, MICROBIAL