Objective: Bloodstream infection (BSI) is one of the major causes of morbidity and mortality associated with sepsis in the world. The aim of this retrospective study is to investigate positive blood cultures in adult patients with fatal outcome, and to evaluate the results of their blood cultures, the etiology of bacteremia and whether they received appropriate antimicrobial therapy or not.

Methods: Data of patients with fatal outcome who were followed between July and November 2018 were accessed from hospital automation system. The presence of bacteremia before the death (blood culture positivity in the last 7 days) and causative microorganisms were investigated. Demographic data were recorded using a form.

Results: 279 patients with fatal outcome whose blood cultures taken before death, were examined. A hundred (36%) patients whose blood cultures were taken up to 7 days before death were evaluated. In 39 (39%) of 100 patients blood cultures were positive. The median age was 65 (ranging from 19 to 96) years and 55 patients were male. 41 (41%) of patients have at least one chronic illness. Hypertension (39%) and diabetes mellitus (29%) were the most common diseases. 43% of patients have a malignancy diagnosis. The mean Charlson comorbidity index score was 7.62±4.3 (ranging from 0 to 18). Ninety four (94%) patients were hospitalized in an intensive care unit. A secondary infection was detected in 81 patients. The most common infections were pneumonia (53.8%) and intraabdominal infection (17.5%). The most frequent causative agent was Acinetobacter baumannii (33.3%) in 39 blood culture-positive patients. Of these pathogens, 21 (53.8%) were detected in peripheral blood, 7 (17.9%) in catheter and 11 (28.2%) were detected in both cultures. Two of 4 Escherichia coli strains were extended spectrum beta-lactamase-positive and one of them was carbapenem-resistant. Four of 7 Klebsiella pneumoniae strains were carbapenem-resistant. Empirical antibiotics were started in 35 patients with positive blood cultures and treatment was not appropriate for 16 patients.

Conclusions: Mortality rates of the bacteremia are increasing day by day, because of the increase of resistant Gram-negative pathogens.These rates are higher in patients who are followed in intensive care unit in particular. Starting empirical antibiotherapy in the early stages may be life-saving for these patients.

Klimik Dergisi 2020; 33(3): 281-5.

Cite this article as: Kalın-Ünüvar G, Çetinkaya F, Türe-Yüce Z, Ulu-Kılıç A. [Retrospective evaluation of positive blood culture of bacteremic cases with fatal outcome]. Klimik Derg. 2020; 33(3): 281-5. Turkish.