Acta Medica Medianae (Jan 2006)
IMPORTANCE OF HEMOCULTURE IN DIAGNOSIS OF BACTEREMIA AND SEPSIS
Abstract
Almost all kinds of microorganisms from blood can be isolated by hemoculture. The isolate consists of 75–85% Gram negative and Gram positive bacteria, until the other part of the isolate consists of fungi or other microorganisms.During the three-year period (1998–2001) we analyzed microbiological characteristics of all positive hemocultures inspected in microbiological laboratory in the Public Health Institute in Nis as well as clinical parameters of patients with the aim of determining the cause of bacteremia. We applied standard microbiologic methods for inspection of 1995 hemocultures taken from 759 patients whereupon we registered positive medical findings in 18,75%. In the majority of cases only one kind of microorganisms was isolated, while in 1.06% of positive hemocultures we isoleted two kinds of microorganisms.Isolation of Streptococcus b heamolyticus gr. A, Streptococcus pneumoniae, E.coli, Proteus mirabilisa, Salmonellae enteritidis, Pseudomonas aeruginose i Candide spp confirms bacteremia. Difteroids and Bacillus spp. were isolated only from contaminated hemocultures. Staphylococcus epidermidis is the most frequent contminant and causes bacteremia in the patients with intravascular catheter and patients on intravenous and peritoneal dialysis. A similar finding of α hemolitic streptococcus of viridans group was registered in the patients with subacute and acute endocarditis who had had an intravenous catheter implanted.On the basis of the results obtained, we can conclude that microorganisms from groups of Streptococcus, Staphylococcus, Candida and Enterobacteriaceace family are the most frequent causes of bacteremia. Beside its limiting factors (time of sampling, duration of incubation, possible contamination of samples, number of hemocultures), hemoculture is the only method by which the causes of bacteremia and sepsis can be isolated.
