RESUMO
In Instituto de Cardiología y Cirugía Cardiovascular, Fundación Favaloro, between January 1996 and October 1999, 10,793 blood cultures and 942 episodes of bacteremia, corresponding to 1883 positive blood cultures, were studied by means of the Bact-Alert System (Organon Teknika), 94% being monomicrobial episodes. Gram positive bacteria were isolated in 45%, Gram negative in 52% and fungi in 3% of episodes. Associated foci of infection were: catheters 36.5%, mediastinitis 9%, pneumonia 6%, endocarditis 6%, abdominal 6%, urinary tract infections 9%, prosthesis 2.6%, empyema 0.2%, arthritis 0.1%, skin and soft tissue 2.5%, diarrhea 0.1%, aortic aneurysm 0.2%, meningitis 0.2%, pericarditis 0.3%, endarteritis 0.1%, infusion fluids 0.2% and unknown 21%. Median time (in hours) for positivization of blood cultures according to different foci were: catheters 16.4, mediastinitis 19.2, pneumonia 14.2, endocarditis 14.5, abdominal infections 11.8, urinary tract infections 13.0 and unknown origin 19.0. As for contaminating microorganisms, the value was 30.5. Seventy two percent of blood cultures became positive within 24 h, and 87% within 48 h; only 1% became positive between 5th and 7th day. There were no important differences in time to detect positive cultures according to different foci. It was not useful to incubate blood cultures more than five days, except for special circumstances, because it does not improve recovery of clinically significant microorganisms.
Assuntos
Bacteriemia/epidemiologia , Bactérias/isolamento & purificação , Técnicas Bacteriológicas , Serviço Hospitalar de Cardiologia/estatística & dados numéricos , Infecção Hospitalar/epidemiologia , Argentina/epidemiologia , Bacteriemia/diagnóstico , Bacteriemia/microbiologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/microbiologia , Feminino , Fungemia/diagnóstico , Fungemia/epidemiologia , Fungemia/microbiologia , Fungos/isolamento & purificação , Humanos , Masculino , Manejo de Espécimes/estatística & dados numéricos , Fatores de TempoRESUMO
Entre enero de 1996 y octubre de 1999, se estudiaron en el Instituto Cardiovascular, Fundación Favaloro, 10.793 hemocultivos y 942 episodios de bacteriemia. Utilizando el Sistema Bact-Alert (Organon Teknika) estos cultivos fueron positivos en 1.883 casos. 94 por ciento de los episodios fueron monomicrobianos. Del total de espisodios se aislaron 45 por ciento de bacterias gram positivas, 52 por ciento de gram negativas y 3 por ciento de hongos. Los focos de infección asociados fueron: 36,5 por ciento infecciones asociadas a catéteres, 9 por ciento mediastinitis, 9 por ciento infecciones urinarias, 6 por ciento neumonías, 6 por ciento endocarditis, 6 por ciento infecciones intraabdominales, 2,6 por ciento infecciones de prótesis, 2,5 por ciento infecciones de piel y partes blandas, 0,3 por ciento pericarditis, 0,2 por ciento meningitis, 2 por ciento empiemas, 0,2 por ciento aneurismas de aorta, 0,2 por ciento infecciones por líquido de infusión contaminado, 0,1 por ciento artritis, 0,1 por ciento endarteritis, 0,1 por ciento diarreas, y foco desconocido en 21 por ciento de los casos. La mediana en horas para positivización de los hemocultivos acorde a los distinto focos fue: 16,4 para infecciones asociadas a catéteres, 19,2 mediastinitis, 14,2 neumonías, 14,5 endocarditis, 11,8 infecciones intraabdominales, 13 infecciones urinarias y 19 para bacteremias de origen desconocido. El valor fue de 30,5 h para las contaminaciones. El 72 por ciento de los hemocultivos positivos con un microorganismo considerado como clínicamente significativo se detectó a las 24 h, 87 por ciento dentro de las 48 h y sólo 1 por ciento entre el 5º y 7º día. No hubo diferencias importantes en el tiempo de detección de hemocultivos positivos acorde a distintos focos. Tampoco resultó de utilidad la incubación de las botellas más allá del 5º día, excepto para circunstancias especiales, puesto que no m
Assuntos
Humanos , Bacteriemia/microbiologia , Bacteriemia/epidemiologia , Bacteriemia/etiologia , Monitoramento Ambiental , ArgentinaRESUMO
Entre enero de 1996 y octubre de 1999, se estudiaron en el Instituto Cardiovascular, Fundación Favaloro, 10.793 hemocultivos y 942 episodios de bacteriemia. Utilizando el Sistema Bact-Alert (Organon Teknika) estos cultivos fueron positivos en 1.883 casos. 94 por ciento de los episodios fueron monomicrobianos. Del total de espisodios se aislaron 45 por ciento de bacterias gram positivas, 52 por ciento de gram negativas y 3 por ciento de hongos. Los focos de infección asociados fueron: 36,5 por ciento infecciones asociadas a catéteres, 9 por ciento mediastinitis, 9 por ciento infecciones urinarias, 6 por ciento neumonías, 6 por ciento endocarditis, 6 por ciento infecciones intraabdominales, 2,6 por ciento infecciones de prótesis, 2,5 por ciento infecciones de piel y partes blandas, 0,3 por ciento pericarditis, 0,2 por ciento meningitis, 2 por ciento empiemas, 0,2 por ciento aneurismas de aorta, 0,2 por ciento infecciones por líquido de infusión contaminado, 0,1 por ciento artritis, 0,1 por ciento endarteritis, 0,1 por ciento diarreas, y foco desconocido en 21 por ciento de los casos. La mediana en horas para positivización de los hemocultivos acorde a los distinto focos fue: 16,4 para infecciones asociadas a catéteres, 19,2 mediastinitis, 14,2 neumonías, 14,5 endocarditis, 11,8 infecciones intraabdominales, 13 infecciones urinarias y 19 para bacteremias de origen desconocido. El valor fue de 30,5 h para las contaminaciones. El 72 por ciento de los hemocultivos positivos con un microorganismo considerado como clínicamente significativo se detectó a las 24 h, 87 por ciento dentro de las 48 h y sólo 1 por ciento entre el 5§ y 7§ día. No hubo diferencias importantes en el tiempo de detección de hemocultivos positivos acorde a distintos focos. Tampoco resultó de utilidad la incubación de las botellas más allá del 5§ día, excepto para circunstancias especiales, puesto que no mejoró la recuperación de microorganismos clínicamente significativos.
Assuntos
Humanos , Argentina , Bacteriemia , Monitoramento AmbientalRESUMO
In Instituto de Cardiología y Cirugía Cardiovascular, Fundación Favaloro, between January 1996 and October 1999, 10,793 blood cultures and 942 episodes of bacteremia, corresponding to 1883 positive blood cultures, were studied by means of the Bact-Alert System (Organon Teknika), 94
being monomicrobial episodes. Gram positive bacteria were isolated in 45
, Gram negative in 52
and fungi in 3
of episodes. Associated foci of infection were: catheters 36.5
, mediastinitis 9
, pneumonia 6
, endocarditis 6
, abdominal 6
, urinary tract infections 9
, prosthesis 2.6
, empyema 0.2
, arthritis 0.1
, skin and soft tissue 2.5
, diarrhea 0.1
, aortic aneurysm 0.2
, meningitis 0.2
, pericarditis 0.3
, endarteritis 0.1
, infusion fluids 0.2
and unknown 21
. Median time (in hours) for positivization of blood cultures according to different foci were: catheters 16.4, mediastinitis 19.2, pneumonia 14.2, endocarditis 14.5, abdominal infections 11.8, urinary tract infections 13.0 and unknown origin 19.0. As for contaminating microorganisms, the value was 30.5. Seventy two percent of blood cultures became positive within 24 h, and 87
within 48 h; only 1
became positive between 5th and 7th day. There were no important differences in time to detect positive cultures according to different foci. It was not useful to incubate blood cultures more than five days, except for special circumstances, because it does not improve recovery of clinically significant microorganisms.
RESUMO
Between February and September 1997, 6588 blood cultures at the Instituto de Cardiología y Cirugía Cardiovascular and Hospital de Niños Ricardo Gutiérrez were studied by using the Bact-Alert system (Organon Teknika) 341 contaminants and 294 episodes of bacteremia (600 samples) were analyzed. From these samples, 280 (95.3%) were monomicrobial episodes and 14 (4.7%) polymicrobial episodes. Positive blood cultures detected by the Bact-Alert system were processed and then reincubated during 7 days, when they were Gram stained and subcultured in blood agar, chocolate agar (both in 5-10% CO2), laked blood agar supplemented with hemin and vitamin K in anaerobic atmosphere (only anaerobic bottles) and CLDE (aerobic conditions). Following reincubation, 3 out of 14 polymicrobial bacteremias were detected, rising the level of detection from 3.7% to 4.7%. Taking into account the total number of bacteremias, only in 3 out of 294 (1%), a second microorganism was detected. Otherwise, in blood cultures where a contaminating microorganism was initially isolated, no further isolates representing a true bacteremia were recovered. Reincubation and terminal subculture of initially positive blood cultures did not provide relevant data in order to change therapeutic measures in the studied population. Due to the increase in costs and labor we consider that this methodology is not routinely advised.
Assuntos
Bacteriemia/diagnóstico , Sangue/microbiologia , Humanos , Técnicas Microbiológicas , Kit de Reagentes para DiagnósticoRESUMO
Between February and September 1997, 6588 blood cultures at the Instituto de CardiologYa y CirugYa Cardiovascular and Hospital de Niños Ricardo GutiUrrez were studied by using the Bact-Alert system (Organon Teknika) 341 contaminants and 294 episodes of bacteremia (600 samples) were analyzed. From these samples, 280 (95.3) were monomicrobial episodes and 14 (4.7) polymicrobial episodes. Positive blood cultures detected by the Bact-Alert system were processed and then reincubated during 7 days, when they were Gram stained and subcultured in blood agar, chocolate agar (both in 5-10 CO2), laked blood agar supplemented with hemin and vitamin K in anaerobic atmosphere (only anaerobic bottles) and CLDE (aerobic conditions). Following reincubation, 3 out of 14 polymicrobial bacteremias were detected, rising the level of detection from 3.7 to 4.7. Taking into account the total number of bacteremias, only in 3 out of 294 (1), a second microorganism was detected. Otherwise, in blood cultures where a contaminating microorganism was initially isolated, no further isolates representing a true bacteremia were recovered. Reincubation and terminal subculture of initially positive blood cultures did not provide relevant data in order to change therapeutic measures in the studied population. Due to the increase in costs and labor we consider that this methodology is not routinely advised.(AU)
Assuntos
Humanos , Bacteriemia/diagnóstico , Sangue/microbiologia , Técnicas Microbiológicas , Kit de Reagentes para DiagnósticoRESUMO
Between February and September 1997, 6588 blood cultures at the Instituto de CardiologÝa y CirugÝa Cardiovascular and Hospital de Niños Ricardo GutiÚrrez were studied by using the Bact-Alert system (Organon Teknika) 341 contaminants and 294 episodes of bacteremia (600 samples) were analyzed. From these samples, 280 (95.3) were monomicrobial episodes and 14 (4.7) polymicrobial episodes. Positive blood cultures detected by the Bact-Alert system were processed and then reincubated during 7 days, when they were Gram stained and subcultured in blood agar, chocolate agar (both in 5-10 CO2), laked blood agar supplemented with hemin and vitamin K in anaerobic atmosphere (only anaerobic bottles) and CLDE (aerobic conditions). Following reincubation, 3 out of 14 polymicrobial bacteremias were detected, rising the level of detection from 3.7 to 4.7. Taking into account the total number of bacteremias, only in 3 out of 294 (1), a second microorganism was detected. Otherwise, in blood cultures where a contaminating microorganism was initially isolated, no further isolates representing a true bacteremia were recovered. Reincubation and terminal subculture of initially positive blood cultures did not provide relevant data in order to change therapeutic measures in the studied population. Due to the increase in costs and labor we consider that this methodology is not routinely advised.
Assuntos
Humanos , Bacteriemia , Sangue , Técnicas Microbiológicas , Kit de Reagentes para DiagnósticoRESUMO
Between February and September 1997, 6588 blood cultures at the Instituto de Cardiología y Cirugía Cardiovascular and Hospital de Niños Ricardo Gutiérrez were studied by using the Bact-Alert system (Organon Teknika) 341 contaminants and 294 episodes of bacteremia (600 samples) were analyzed. From these samples, 280 (95.3
) were monomicrobial episodes and 14 (4.7
) polymicrobial episodes. Positive blood cultures detected by the Bact-Alert system were processed and then reincubated during 7 days, when they were Gram stained and subcultured in blood agar, chocolate agar (both in 5-10
CO2), laked blood agar supplemented with hemin and vitamin K in anaerobic atmosphere (only anaerobic bottles) and CLDE (aerobic conditions). Following reincubation, 3 out of 14 polymicrobial bacteremias were detected, rising the level of detection from 3.7
to 4.7
. Taking into account the total number of bacteremias, only in 3 out of 294 (1
), a second microorganism was detected. Otherwise, in blood cultures where a contaminating microorganism was initially isolated, no further isolates representing a true bacteremia were recovered. Reincubation and terminal subculture of initially positive blood cultures did not provide relevant data in order to change therapeutic measures in the studied population. Due to the increase in costs and labor we consider that this methodology is not routinely advised.