PERİFERİK KAN KÜLTÜRÜ VE YÖNETİMİ

Authors : Seda ARDAHAN SEVGİLİ, Figen YARDIMCI

Pages : 153-162

View : 16 | Download : 8

Publication Date : 2017-12-27

Article Type : Review Paper

Abstract :Başlık: PERİFERİK KAN KÜLTÜRÜ VE YÖNETİMİ Title:  PERIPHERAL BLOOD CULTURE AND MANAGEMENT Özet:  Kan dolaşımı enfeksiyonları; enfeksiyona neden olan mikroorganizma ile etkilediği canlı arasında birçok etkileşim sonucunda meydana gelen ve oldukça karmaşık bir süreçtir. Bundan dolayı kan dolaşımı enfeksiyonlarının erken dönemde tanılanması ve tanısına yönelik tedavisinin başlatılması yaşamsal önem taşımaktadır. Kan kültürleri; ciddi kan dolaşımı enfeksiyonlarının tanımlanması ve uygun antimikrobiyal tedavinin seçiminde kullanılan tanılama testlerinin en önemlisidir. Teknolojinin gelişmesiyle birlikte, her geçen gün tanı ve tedavi tekniklerinde yeni gelişmeler olmaktadır, ancak; bakteriyemi ve fungeminin tespitinde kan kültürleri hala en uygun teknik olma niteliğini sürdürmektedir . Periferik kan kültürü alımı yaparken sağlık çalışanlarının dikkat etmesi gereken durumlardan biri deri kontaminasyonuna bağlı yalancı-pozitif kan kültürüdür. Yalancı-pozitif kan kültürlerinin hem tedavi görmekte olan hastalar hem de sağlık sistemi açısından oldukça fazla olumsuz etkisi bulunmaktadır. Test sonuçlarının yalancı-pozitif olduğu fark edilmez ise, sağlık çalışanları tarafından aslında gerekli olmayan çok sayıda tanı-tedavi yöntemi uygulanmak zorunda kalınmaktadır. Abstract:  Bloodstream infection is a very complicated process that occurs as a result of many interactions between the infecting microorganism and the living organism. Therefore, it is essential to initiate early diagnosis of bloodstream infections and treatment. Blood cultures are the most important diagnostic tests used for identification of severe bloodstream infections and selection of appropriate antimicrobial therapy. With the development of technology, there are new developments in diagnosis and treatment techniques every passing day but; blood cultures still remain the most appropriate technique for the detection of bacteraemia and fungemia. One of the situations that health care workers should be aware of when taking peripheral blood culture is a false-positive blood culture due to skin contamination. False-positive blood cultures have considerable negative effects on both the treated patients and the health system. If it is not noticed that the test results are false-positive, a large number of diagnostic and therapeutic methods that are not actually needed have to be done by healthcare professionals.  Anahtar kelimeler:  yalancı-pozitif, kan dolaşımı enfeksiyonu, enfeksiyon kontrolü Keywords:  false-positive, bloodstream infection, infection control Destekleyen kurumlar: Kaynakça:  Alahmadi YM, McElnay JC, Kearney MP ve ark . Tackling the problem of blood culture contamination in the intensive care unit using an educational intervention. Epidemiology&Infection 2015;143(9):1964-1971. Bekeris LG, Tworek JA, Walsh MK ve ark. Trends in blood culture contamination: a college of american pathologists q-tracks study of 356 institutions. Archives of Pathology&Laboratory Medicine 2005;129:1222–1225. Boyce JM, Nadeau J, Dumigan D ve ark. Obtaining blood cultures by venipuncture versus from central lines: ımpact on blood culture contamination rates and potential effect on central line–associated bloodstream infection reporting. Infection Control and Hospital Epidemiology 2013;34(10):1042104-7. Chang YT, Lin CY, Lu PL ve ark. Stenotrophomonas maltophilia bloodstream infection: comparison between community-onset and hospital-acquired infections. Journal of Microbiology, Immunology and Infection 2014;47:28-35. Clinical and Laboratory Standards Institute (CLSI). Principles And Procedures For Blood Cultures; Approved Guideline. CLSI Document M47-A . Clinical & Laboratory Standards Institute 2007;27(17); [cited 2016 February 3] . Available frrom: http://shop.clsi.org/site/Sample_pdf/M47A_sample.pdf . Cockerill FR III, Wilson JW, Vetter EA ve ark. Optimal testing parameters for blood cultures. Clinical Infectious Disease 2004; 38(12):1724-1730. Çiçek A. Kan kültür sonuçlarının değerlendirilmesinde etkili olan faktörler. İnönü Üniversitesi Tıp Fakültesi Dergisi 2005;12(4):277-280. Çöloğlu D. Yalancı Pozitif Üreme Sinyali Veren Otomatize Kan Kültürü Şişelerinde Polimeraz Zincir Reaksiyonu (Pzr) Yöntemi İle Bakteri ve Mantar Varlığının Araştırılması. [Tıpta Uzmanlık Tezi]. Ankara: Ankara Üniversitesi Tıp Fakültesi; 2012. Gander RM, Byrd L, DeCrescenzo M  ve ark. Impact of blood cultures drawn by phlebotomy on contamination rates and health care costs in a hospital emergency department. Journal of Clinical Microbiology 2009;47(4):1021-4 Gilligan PH. Blood culture contamination: a clinical and financial burden. Infection Control&Hospital Epidemiology 2013;34(1):22-23 . Hall KK, Lyman JA. Updated review of blood culture contamination. Clinical Microbiology Reviews 2006;19:788-802. Harbarth S, Garbino J, Pugin J ve ark. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. American Journal of Medicine 2003;115:529-535. Isenberg HD. Clinical Microbiology Procedures Handbook [e-book]. Washington, DC: ASM Press; 2004. [cited 2016 January 10]. Available from:   http://en.bookfi.net/book/1306334 . Lee A, Mirrett S, Reller LB ve ark. Detection of bloodstream infections in adults: how many blood cultures are needed? Journal of Clinical Microbiology 2007;45(11):3546-3548. Liu W , Duan Y ,  Cui W ve ark. Skin antiseptics in venous puncture site disinfection for preventing blood culture contamination: a bayesian network meta-analysis of randomized controlled trials. International Journal of Nursing Studies 2016;59:156-162. Maiwald M, Chan SY. Pitfalls in evidence assessment: the case of chlorhexidine and alcohol in skin antisepsis. Journal of Antimicrobial Chemotheraphy 2014;69(8):2017-2021. Maiwald M, Chan SY. The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. PLoS One  2012;7(9):e44277. Murphy T, Maile D, Barsch T. Investigating the ımpact of blood culture bundles on the incidence of blood culture contamination rates, The Art And Science of Infusion Nursing 2014;37(3):205-210. Murray PR, Masur H. Current approaches to the diagnosis of bacterial and fungal bloodstream infections in the intensive care unit. Critical Care Medicine 2012;40:3277-3282. Murty DS, Gyaneshwari M. Blood cultures in paediatric patients: a study of clinical impact. Indian Journal of Medical Microbiology 2007;25(3):2022-2024. Mylotte JM, Tayara A. Blood culture: clinical aspects and controversies. European Journal of Clinical Microbiology&Infectious Diseases 2000;19:157-163. O’Connor C, Philip RK, Powell J ve ark. Combined education and skin antisepsis intervention for persistently high blood-culture contamination rates in neonatal intensive care. Journal of Hospital Infection 2016; 93(1):105-107. Pavlovsky M, Press J, Peled N ve ark. Blood culture contamination in pediatric patients: young children and young doctors. The Pediatric Infectious Disease Journal 2006;25(7):611–614. Pien BC, Sundaram P, Raoof N ve ark.  The clinical and prognostic importance of positive blood cultures in adults. The American Journal of Medicine 2010;123(9):819-828. Self HW,   Mickanin J ,   Grijalva CG ve ark. Reducing blood culture contamination in community hospital emergency departments: multicenter evaluation of a quality improvement intervention, Academic Emergency Medicine 2014;21(3):274–282. Self HW, Speroff T, McNaughton CD ve ark. Blood culture collection through peripheral intravenous catheters increases the risk of specimen contamination among adult emergency department patients. Infection Control and Hospital Epidemiology 2012;33(5):524-526.  Singhal T. Blood cultures revisited. Pediatric Infectious Disease 2012;4(1):25–27. Smith BA, Peterson LR. Best way to prevent blood culture contamination. Medscape 2014 SHEA Expert commentaries. Snyder JW. Blood cultures: The importance of meeting pre-analytical requirements in reducing contamination, optimizing sensitivity of detection, and clinical relevance, Clinical Microbiology Newsletter 2015;37(7):53-57. Stonecypher K. Going around in circles. Critical Care Nursing 2009;32:94-98. Taneja D, Finney J, Nagaishi K. A performance improvement project: reducing emergency department blood culture contamination rate using six sigma methodology. American Journal of Infection Control 2014; 42: 29-166 Towns ML, Jarvis WR, Hsueh P. G uidelines on blood cultures. journal of microbiology, İmmunology anf Infection 2010;43(4):347- 34 9 . Wanga P, Hub B. Strategies on reducing blood culture contamination, Reviews in Medical Microbiology 2012;(23) : 63–66. Willock J, Richardson J ,  Brazier A ve ark. Peripheral venepuncture in infants and children. Nursing Standard 2004;18(27):43-50. Youssef D, Shams W, Bailey B ve ark. Effective strategy for decreasing blood culture contamination rates: the experience of a veterans affairs medical centre. Journal of Hospital Infection 2012;81:288-291. Zarbo RJ ,   Jones BA ,   Friedberg RC ve ark. Q-tracks: a College of American Pathologists program of continuous laboratory monitoring and longitudinal tracking. Archives of Pathology& Laboratory Medicine 2002;126:1036-1044.
Keywords : yalancı pozitif, kan dolaşımı enfeksiyonu, enfeksiyon kontrolü