Hemodiyaliz hastalarında kan kültürü sonuçlarının değerlendirilmesi

Amaç: Hemodiyaliz kronik böbrek yetmezliği (KBY) gelişen hastalarda hayat kurtarıcı invaziv bir işlemdir. Ancak, bu işlemde kateter uygulamasına bağlı olarak sıklıkla hasta ölümlerine neden olan enfeksiyonlar gelişebilmektedir. Bu enfeksiyonlar hastaların kan ve/veya kateter kültürlerinin izlenmesi ile tespit edilir. Bu çalışmada, epidemiyolojik verilere katkı sunmak amacıyla hemodiyaliz uygulanan KBY hastalarının kan kültürü sonuçlarının bir analizi yapılmıştır. Yöntem: Bu çalışmada 2017-2020 yılları arasında SBÜ Samsun Eğitim ve Araştırma Hastanesi Hemodiyaliz Ünitesi’nde kateter enfeksiyonu olduğu düşünülen hastaların kültür sonuçları retrospektif olarak değerlendirildi. Laboratuvara gönderilen kan kültürleri bir hafta süre boyunca hemokültür cihazında (Render, China) inkübe edildi ve üreme varlığı takip edildi. Cihazda üreme görülen örneklere otomatik bakteri identifikasyon cihazı VITEK® 2 (BioMérieux, France) ile tanımlama ve antibiyogram işlemi yapıldı. Bulgular: Kateter ilişkili bakteriyemi ve kateter enfeksiyonu düşünülerek kan kültürü istenen 56 hastanın 34 (%60,7)’ü erkek ve 22 (%39,3)’si kadındır. Hastaların yaş ortalaması 62,38±14,8 idi. Hastaların 35(%62,5)’inden çeşitli patojenler izole edilmiştir. Olguların 5 (%8,9)’inde iki farklı bakteri birlikte üremiştir. Koagülaz negatif stafilokoklar tek başına ve başka bir organizmayla birlikte toplamda 24 suşla (%42,9) en sık üreyen organizmalar olmuş, bunu toplamda 6 suşla (%10,7) S. aureus izlemiştir. Pseudomonas aeruginosa (%5,4), Enterococcus faecalis (%3,6), E. coli, Enterobacter cloacae complex (%3,6) ve Klebsiella pneumoniae (%1,8) kan kültürlerinden izole edilen diğer organizmalar olmuştur. Koagülaz negatif stafilokokların 17 (%70,8)’si penisiline ve 18 (75,0)’i metisiline dirençli bulunmuştur. S. aureus suşlarının ise 3 (%50,0)’ü penisiline 3 (%50,0)’ü de metisiline dirençli bulunmuştur. Kan kültürlerinde KNS ve S. aureus üremesi arasında istatistiksel olarak anlamlı fark olduğu saptanmıştır (p

Evaluation of blood culture results in hemodialysis patients

Objective: Hemodialysis is a life-saving invasive procedure in patients with chronic renal failure (CRF). However, in this procedure, infections, which often cause patient deaths, may develop due to catheter application. These infections are detected by monitoring the blood and/or catheter cultures of the patients. In the study, an analysis of the blood culture results of patients with CRF undergoing hemodialysis was performed in order to contribute to the epidemiological data. Methods: In this study, the culture results of patients who were thought to have catheter infection in the Hemodialysis Unit of SBU Samsun Training and Research Hospital between 2017 and 2020 were evaluated retrospectively. Blood cultures sent to the laboratory were incubated in the hemoculture device (Render, China) for one week and the presence of growth was monitored. Identification and antibiogram procedures were performed with the automatic bacteria identification device VITEK® 2 (BioMérieux, France). Results: Of the 56 patients whose blood culture was requested considering catheter-related bacteremia and catheter infection, 34 (60.7%) were male and 22 (39.3%) were female. The mean age of the patients was 62.38±14.8. Various pathogens were isolated from 35 (62.5%) of the patients. Two different bacteria grew together in 5 (8.9%) of the cases. Coagulase negative staphylococci alone or together with another organism were the most frequently reproduced organisms with a total of 24 strains (42.9%), followed by S. aureus with a total of 6 strains (10.7%). Other organisms isolated from blood cultures were Pseudomonas aeruginosa (5.4%), Enterococcus faecalis (3.6%), E. coli, Enterobacter cloacae complex (3.6%), and Klebsiella pneumoniae (1.8%). Of the coagulase-negative staphylococci, 17 (70.8%) were resistant to penicillin and 18 (75.0) to methicillin. Of the S. aureus strains, 3 (50.0%) were found to be resistant to penicillin and 3 (50.0%) to methicillin. A statistically significant difference was found between CNS and S. aureus growth in blood cultures (p

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