Murat KONAK, Muhammed Yaşar KILINÇ, İbrahim DİKMEN, Saime Sündüs UYGUN, Hatice TÜRK DAĞI, Hanifi SOYLU

Yenidoğan Yoğun Bakım Ünitesinde Çift Kan Kültürü Politikası Tekliden Daha Etkili

Amaç: Yenidoğan Yoğun Bakım Ünitelerinde (YYBB) kan kültürü örneklemesi ve antibiyotik uygulaması yaygın uygulamalardır. Ancak yanlış pozitif kültür sonuçları klinisyenin kararını etkileyebilir ve uygun olmayan antibiyotik tedavilerine yol açabilir. Bu çalışma çift kültürün klinik uygulamaya etkisini araştırmak amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışma retrospektif olarak yapıldı. 2016-2019 yılları arasında YYBÜ'ye başvuran hastaların kan kültürü sonuçları incelendi. 2017 öncesi dönemde sepsis düşünüldüğünde hastalarımızdan sadece bir örnek alıyorduk. Bu süreden sonra çift kan kültürü almaya başladık. Kan kültürleri alım zamanına göre; ilk olarak erken ve geç başlangıçlı sepsis olmak üzere iki gruba, ardından alt gruplara; a-) Grup 1, ilk 24 saatte kültür, b-)Grup 2, 24-72 saat ve c-)Grup 3, 72 saatten sonra kan kültürü alınanlar olarak gruplandırıldı. Bulgular: Çalışmada toplam 1747 kültür örneği alındı. Kan kültürlerinin çoğu Grup 3'teydi (%62). Erkek/kadın oranı 1.3:1 idi. Staphylococcus Epidermidis(S. Epi), kontaminasyon için ana etkendi. Ancak, çift kan kültürü alarak, Grup 2'deki (%11'e karşı %3) ve Grup 3'teki (%41 ila %14) çoğu S.Epi kontaminasyonunu ortadan kaldırmayı başardık. Ayrıca çift kan kültürü alarak bir kolda bazı dirençli Gr(-) patojenleri diğer kol negatif olmasına rağmen tespit edebildik. Sonuçlar: Çalışmamız, YYBB'lerde çift kan kültürü politikasının klinisyenlere antibiyotik kullanımında mantıklı karar vermelerine yardımcı olabileceğini ve bebeklerin gereksiz antibiyotik maruziyetini azaltabileceğini göstermektedir. Ayrıca bazı patojen mikroorganizmaların kolaylıkla tespit edilmesini sağlayabilir.

Anahtar Kelimeler:

Yenidoğan, Septisemi, Kan kültürü, Koagülaz Negatif Stafilokoklar, Kontaminasyon

Double Blood Culture Policy Is More Effective Than Single In Neonatal Intensive Units

Aim: Blood culture (BC) sampling and antibiotic administration are common practices in Neonatal Intensive Care Units(NICUs). However, false positive BC results might affect clinician’s decision and lead to inappropriate antibiotic treatments. The aim of this study was to investigate the effect of double culture on clinical application. Material and Methods: The study was conducted retrospectively. The blood culture results of the patients admitted to the NICU between 2016-2019 were analyzed. Considering sepsis before 2017, we took only one sample from the patient. After this period, we started to take double blood cultures. Time frames of BCs were investigated to two groups as early and late onset sepsis fistly, and then subgroups as; a-) Group 1, BCs in the first 24 hours, b-)Group 2, between 24 to 72 hours, and c-)Group 3, after 72 hours. Results: Total of 1747 BC samples were taken in study. Majority of BCs were in Group 3(62%). Male/female ratio was 1.3:1. Staphylococcus Epidermidis(S. Epi) was major source for the contamination. But, by taking dBCs, we were able to eliminate most S.Epi contamination in Group 2 (11%vs.3%) and in Group 3(41%to14%). We were able to identify some resistant Gr(-) pathogens in one arm although the other arm was negative, by taking dBC. Conclusions: Our study indicates that dBC policy in NICUs could help to clinicians for judicious decision in antibiotic use and decrease unnecessary antibiotic exposure of infants. Also it could be enable to detect some highly pathogen microorganism easily. Key words: Newborn, Septicemia, Blood culture, Coagulase Negative Staphylococci, contamination

Keywords:

Newborn, Septicemia, Blood culture, Coagulase Negative Staphylococci, contamination,

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