Acil Serviste Alınan Kan Kültürlerinin Tedavi Seyrini Etkileri

Abstract

ONAT A.Effect of the blood culture to the treatment’s prognose in the emergency servise. Hacettepe Universitiy Faculty of Medicine Department of Emergency Medicine Master thesis Ankara,2019. Blood cultures are gold standart for the diagnosis of bacteremia. 4-7% of the blood cultures are positive. Because of the contamination, more expensive hospitilizations, unnecessery antibioterapies and admissions also poor income are present. In this retrospective study, patients whose blood culture was taken in the Hacettepe University Adult Emergency Service were analyzed. 1068 patients were attended to this study. The percentage of equal and over 65 years old patients was 53,4. 0,5% of the patients had generalized weakness. The most accompanying comorbid disease was 49,3% cardiovascular diseases. The most blood culture had taken triage level was T3 by 51,7%. Patients whose fever was equal and over 38,2°C had 37%. The most common diagnoses at admission we-re 17,9% pneumonia and 15,5% fever. The most common diagnoses at discharge were 18,2% pneumonia, 6,1% urinary tract infection, 4,2% local infection and 3,8% sepsis. The most common pathogen bacteria isolated from positive blood culture was 16,6% E.coli. 52,5% of the positive blood cultures were contaminants. According to the results of blood cultures, no antibiotic treatment modification group had 54,3% and the treatment modification group had 5% and the new antibiotic group had 0,6%. Median length of stay in emergency service was 24 hours. 29,9% of the patients had hospitalized and 17,9% of the patients had discarged. Mortality of the patients was 5,9%. Blood cultures should be taken even the patient is not febril or their leukocyte count is normal. Taking blood culture from elderly patients may be useful. In neutropenic patients E.coli must consider as primary agent. Blood culture sampling rules must be obeyed for correct results.