Pediatric blood culture resistance rates from a single centre hospital; how innocent are coagulase-negative staphylococci?

Abstract

Objective: Pediatric blood culture bacteria profile and antibiotic suscep-tibilities vary for each hospital. In this study, it was aimed to determine the bacterial profile in blood cultures from the pediatric age group and study antibiotic susceptibility. In this context, we want to shed light on rational antibiotic use by determining antibiotic resistance rates in pediatric blood cultures and to reduce the number of samples considered as possible contamination by determining the rates of coagulase-negative Staphylococci (CNS). Material and Methods: In this study, positive 96 samples from a total of 326 samples were brought from the pediatric ward to our laborato-ry. The cultures were first taken into the growth period on BD Bactec in blood culture bottles. Positive samples were cultivated in suitable media and incubated at 37°C for 24-48 hours. For the suspected specimens of Brucella, the residence time of the bottles was increased to 21 days. The microorganisms were evaluated by biochemical media for identification, and antibiotic susceptibilities were performed by disc diffusion method. Results: A total of 326 blood samples were cultured. Of the 96 blood cultures with growth, 86 were gram-positive and 10 were gram-nega-tive. While all of the gram-negative bacteria were found to be infectious agents compatible with the patient clinic, the rate of CNS from gram-positive bacteria was found to be about 50% of all bacteria, and the number of patients who had CNS proliferating over the first 12 hours was 48 and positive results were obtained from 27 samples in the first hours. While gram-negative bacteria profiles were found similar to oth-er studies in bacterial susceptibilities, gram-positives were found to be more sensitive. This condition is thought to be based on skin or planting contaminant CNS. Aminoglycoside resistance was found as 25% (n= 24) and vancomycin resistance as 0% (n= 0) in gram-positive bacteria (van-comycin resistance was not found in the blood culture of any patient). Antibiotic resistance rates were as follows: erythromycin 39% (n= 37), cefoxitin 46% (n= 45), ciprofloxacin 46% (n= 44). Conclusion: Detection of CNS in up to fifty percent raises the question of whether the bacterium is active or contaminant. In addition to bacterial planting and sensitization determination, patient care and medicines have high costs for hospitals and the government. The aim of our study was to reflect only the laboratory data and the situation. According to the results, it is thought that increasing precautions to be taken during blood collection will cause a decrease in contamination rates.