Author/Editor		Lejko-Zupanc, Tatjana; Mueller-Premru, Manica
Title		Bakteriemija, sepsa in endokarditis
Type		članek
Source		In: Dragaš AZ, Fišer J, Prinčič D, et al, editors. Zbornik strokovnega srečanja Mikrobiološka analiza kužnin; 1999 okt 22-23; Nova Gorica. Nova Gorica: Zavod za zdravstveno varstvo,
Publication year		1999
Volume		str. 217-24
Language		slo
Abstract		Bacteremia, sepsis and infective endocarditis are serious diseases that demed accurate etiologic diagnosis. To ensure the maximum gain of blood cultures they should be with drawn at the time when the probability of isolating a causative pathogen is the greatest, and in such a way to minimize the possibility of contamination. Blood samples are usually with drawn aseptically when the patient's temperature is rising. Blood should be inoculated in aerobic and anaerobic bottles. On the whole 10% of blood cultures are usually positive. In the year 1998 9671 blood cultures were analyzed on the Institute for microbiology. 1112 bactetia were isolated, namely 634 (57,0%) Gram positive cocci and 380 (34,2%) Gram negative bacilli. In the years 1984 till 1996 205 patients with infective endocarditis were treated at the Department for infectious diseases. In 17,0% of the patients the blood cultures were negative. Most common pathogens were viridans streptococci (29,7%) and staphylococci (17,5%). Pathogenic bacteria (Salmonella, E. coli, Staphylococcus aureus and others) isolated from one or more blood culture bottles are usually the causative agent of sepsis. S. epidermidis and other coagulase negative staphylococci, Bacillus sp., Corynebacterium sp. and Propionibacterium sp. isolated from only one blood culture bottle in a patient without clinical signs of sepsis probably represent contamination during the withdrawal of blood In analyzing blood culture many mistakes are possible. To avoid them, good cooperation of those that the blood cultures and those anlyzing them is necessary.
Summary		Bakteriemija, sepsa in endokarditis so akutna stanja, pri katerih je etiološka diagnoza, ki jo dobimo z analizo kužnin, zelo pomembna. Da bo diagnoza pravilna, morajo biti kužnine odvzete takrat, ko je verjetnost, da bomo povzročitelja izolirali, največja, in tako, da bo mikroorganizem, ki ga izoliramo, res povzročitelj in ne kontaminant. Kri za hemokulture jemljemo aseptično iz periferne vene takrat, ko bolniku temperatura narašča. Kri inokuliramo v dve steklenički eno za aerobne bakterije in glive, drugo pa za anaerobne bakterije. Pozitivnih je približno 10 % poslanih hemokultur. V l.1998 smo na Inštitutu za mikrobiologijo analizirali 9671 vzorcev hemokultur. Izolirali smo 1112 bakterij. Od tegaje bilo 634 (57,0 %) grampozitivnih kokov in 380 (34,2 %) gramnegativnih bacilov iz skupine enterobakterij in nefermentativnih bacilov. Od leta 1984 do leta 1996 je bilo na Kliniki za infekcijske bolezni in vročinska stanja zdravljenih 205 bolnikov z infekcijskim enokarditisom. Hemokuture so bile negativne pri 17%. Najpogosteje osamIjeni povzročitelji so bili viridans streptokoki (29.7%) in stafilokoki (17.5%). Patogeni mikroorganizmi (Salmonella, E. coli, Staphylococcus aureus, itd.) v eni ali več stekleničkah so povzročitelji sepse. S. epidermidis in drugi glede koagulaze negativni stafilokoki, Bacillus sp., Corynebacterium sp. in Propionibacterium sp. v samo eni steklenički pri bolniku, ki nima kliničnih znakov za sepso, verjetno predstavljajo kontaminante, ki smo jih vnesli ob nepravilnem odvzemu krvi. Napak pri analiziranju hemokultur je lahko veliko. Da se jim izognemo, je zelo pomembno dobro in usklajeno delovanje tistih, ki hemokulture jemljejo, in tistih, ki jih analizirajo.
Descriptors		BACTEREMIA ENDOCARDITIS, BACTERIAL SEPSIS BLOOD SPECIMEN COLLECTION BLOOD