Do we need blood cultures for the management of aspiration pneumonia?
Yıl: 2010 Cilt: 32 Sayı: 4 Sayfa Aralığı: 241 - 246 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
Do we need blood cultures for the management of aspiration pneumonia?
Öz: Amaç: Bu çalışmanın amacı kan kültürlerinin aspirasyon pnömonisi tedavisinin düzenlenmesindeki önemini belirlenmesidir.Gereç ve Yöntemler: Aspirasyon pnömonisi tanısı ile izlenen hastalar Enfeksiyon Hastalıkları Kliniği hasta kayıtları geçmişe yönelik olarak taranarak saptandı. Hastaların demografik ve klinik özellikleri dosyaları incelenerek belirlendi.Bulgular: Haziran 2005 ile Ağustos 2008 tarihleri arasında aspirasyon pnömonisi tanısı ile izlenen 50 hasta çalışmaya dahil edildi. Hastaların 35'inde toplumda edinilmiş aspirasyon pnömonisi saptanırken, 15 hastada sağlık hizmeti kaynaklı aspirasyon pnömonisi mevcuttu. Bir hasta solunum yetmezliği nedeni ile kaybedilirken 49 hastada klinik kür elde edilmişti. Elli hastadan 105 kan kültürü alınmıştı. Bunların 27'sinde üreme saptanırken, sadece sekizi gerçek pozitifti. En sık izole edilen bakteri Streptococcus pneumoniae idi. Antibiyotik tedavisi kan kültürü sonucuna göre sadece sağlık hizmeti kaynaklı aspirasyon pnömonisi tanısı ile izlenen hastada değiştirilmişti.Sonuç: Yaptığımız bu geriye yönelik sınırlı çalışmada kan kültürü alınmasının toplumda edinilmiş aspirasyon pnömonisinin tedavisinin düzenlenmesinde faydasını saptayamadık. Sağlık hizmeti kaynaklı aspirasyon pnömonisinde kan kültürün yerini belirleyebilmek için prospektif çalışmalara ihtiyaç vardır.
Anahtar Kelime: Konular:
Aspirasyon pnömonisinde tedavinin düzenlenmesinde kan kültürlerine ihtiyacımız var mı?
Öz: Purpose: The aim of this study was to evaluate the utility of blood cultures for the management of aspiration pneumonia.Material and Methods: The patients who were hospitalized with a diagnosis of aspiration pneumonia were retrospectively identified from the records of Department of Infectious Diseases. The demographic and clinical features of the patients were extracted from the charts.Results: Fifty patients with aspiration pneumonia between June 2005 and August 2008 were included into the study. Thirty-five patients had community acquired aspiration pneumonia while 15 had health-care associated aspiration pneumonia. Clinical cure was achieved at 49 patients while one patient died due to respiratory insufficiency. A total of 105 blood cultures were performed from 50 patients. Twenty-seven blood cultures were initially reported as positive, but only eight were true positive. The most common bacteria isolated from blood cultures were Streptococcus pneumoniae. Antibiotics were changed according to the blood culture result only in one patient with health-care associated aspiration pneumonia.Conclusion: In this retrospective limited study we didn't observe any benefit of the blood cultures for the management of community acquired aspiration pneumonia. Prospective studies are needed to establish the utility of blood cultures in patients with health-care associated aspiration pneumonia.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1) Kikawada M, Iwamoto T, Takasaki M. Aspiration and infection in the elderly: epidemiology, diagnosis and management. Drugs Aging 2005; 22:115-130.
- 2) Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest 2003; 124:328-336.
- 3) Arseven O, Özlü T, Aydın G,ve ark. Solunum Sistemi Enfeksiyonları Çalışma Grubu. Türk Toraks Derneği Erişkinlerde toplumda gelişen pnömoni tanı ve tedavi uzlaşı raporu.Türk Toraks Dergisi. 2002; 3 (Ek 3): 1-15
- 4) The Japanese Respiratory Society guidelines for management of community-acquired pneumonia in adults. Matsushima T; Japanese Respiratory Society. Nippon Rinsho. 2003 ;61 (Suppl 2):677-81.
- 5) Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community- acquired pneumonia in adults. Clin Infect Dis 2007; 44 (Suppl. 2): S27–72.
- 6) Benenson RS, Kepner AM, Pyle DN 2nd, Cavanaugh S. Selective use of blood cultures in emergency department pneumonia patients. J Emerg Med 2007; 33:1-8.
- 7) Chalasasni NP, Valdecanas MA, Gopal AK, McGowan JE, Jurado RL. Clinical utility of blood cultures in adult patients with community-acquired pneumonia without defined underlying risks. Chest 1995; 108:932-936.
- 8) Campbell SG, Marrie TJ, Anstey R, Dickinson G, Ackroyd-Stolarz S. The contribution of blood cultures to the clinical management of adult patients admitted to the hospital with community-acquired pneumonia. Chest 2003; 123:1142-1150.
- 9) Corbo J, Friedman B, Bijur P, Gallagher EJ. Limited Usefulness of initial blood cultures in community acquired pneumonia. Emerg Med J 2004; 21:446-448.
- 10) Kennedy M, Bates DW, Wright SB, Ruiz R, Wolfe RE, Shapiro NI. Do emergency department blood cultures change practice in patients with pneumonia? Ann Emerg Med 2005; 46:393-400.
- 11) Ramanujam P, Rathlev NK. Blood cultures do not change management in hospitalized patients with community-acquired pneumonia. Acad Emerg Med 2006; 13:740-745.
- 12) Waterer GW, Wunderink RG. The influence of the severity of community-acquired pneumonia on the usefulness of blood cultures. Respir Med 2000; 95:78-82.
- 13) Mylotte JM, Goodnough S, Naughton BJ. Pneumonia versus aspiration pneumonitis in nursing home residents: diagnosis and management. J Am Geriatr Soc 2003; 51:17-23.
- 14) Allewelt M, Schüler P, Bölcskei PL, Mauch H, Lode H; Study Group on Aspiration Pneumonia. Ampicillin + sulbactam vs clindamycin +/- cephalosporin for the treatment of aspiration pneumonia and primary lung abscess. Clin Microbiol Infect 2004; 10:163-170.
- 15) Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997; 336: 243–250.
- 16) Abrahamian FM, Deblieux PM, Emerman CL, et al. Health care-associated pneumonia: identification and initial management in the ED. Am J Emerg Med 2008; 26 Suppl 6:1-11.
- 17) Ruhe J, Menon A, Mushatt D, Dejace P, Hasbun R. Non- epidermidis coagulase-negative staphylococcal bacteremia: clinical predictors of true bacteremia. Eur J Clin Microbiol Infect Dis 2004; 23:495-498.
- 18) Kane-Gill SL, Olsen KM, Rebuck JA, et al; Aspiration Evaluation Group of the Clinical Pharmacy and Pharmacology Section. Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients. Ann Pharmacother 2007; 41:549-555.
- 19) Kadowaki M, Demura Y, Mizuno S, et al. Reappraisal of clindamycin iv monotherapy for treatment of mild to moderate aspiration pneumonia in elderly patients. Chest 2005; 127:1276-1282.
- 20) Zwang O, Albert RK. Analysis of strategies to improve cost effectiveness of blood cultures. J Hosp Med 2006; 1:272-6.
- 21) Kucukardali Y, Oncul O, Nalbant S, ve ark. Yaşlı popülasyonda toplum kökenli pnömoni olguları. Geriatri (Turkish Journal of Geriatrics) 2001; 4: 59-62.
| APA | Metan G, BOZKURT İ, YILDIZ O, Alp E, AYGEN B, SÜMERKAN B (2010). Do we need blood cultures for the management of aspiration pneumonia?. , 241 - 246. |
| Chicago | Metan Gökhan,BOZKURT İlkay,YILDIZ Orhan,Alp Emine,AYGEN Bigehan,SÜMERKAN Bülent Do we need blood cultures for the management of aspiration pneumonia?. (2010): 241 - 246. |
| MLA | Metan Gökhan,BOZKURT İlkay,YILDIZ Orhan,Alp Emine,AYGEN Bigehan,SÜMERKAN Bülent Do we need blood cultures for the management of aspiration pneumonia?. , 2010, ss.241 - 246. |
| AMA | Metan G,BOZKURT İ,YILDIZ O,Alp E,AYGEN B,SÜMERKAN B Do we need blood cultures for the management of aspiration pneumonia?. . 2010; 241 - 246. |
| Vancouver | Metan G,BOZKURT İ,YILDIZ O,Alp E,AYGEN B,SÜMERKAN B Do we need blood cultures for the management of aspiration pneumonia?. . 2010; 241 - 246. |
| IEEE | Metan G,BOZKURT İ,YILDIZ O,Alp E,AYGEN B,SÜMERKAN B "Do we need blood cultures for the management of aspiration pneumonia?." , ss.241 - 246, 2010. |
| ISNAD | Metan, Gökhan vd. "Do we need blood cultures for the management of aspiration pneumonia?". (2010), 241-246. |
| APA | Metan G, BOZKURT İ, YILDIZ O, Alp E, AYGEN B, SÜMERKAN B (2010). Do we need blood cultures for the management of aspiration pneumonia?. Erciyes Tıp Dergisi, 32(4), 241 - 246. |
| Chicago | Metan Gökhan,BOZKURT İlkay,YILDIZ Orhan,Alp Emine,AYGEN Bigehan,SÜMERKAN Bülent Do we need blood cultures for the management of aspiration pneumonia?. Erciyes Tıp Dergisi 32, no.4 (2010): 241 - 246. |
| MLA | Metan Gökhan,BOZKURT İlkay,YILDIZ Orhan,Alp Emine,AYGEN Bigehan,SÜMERKAN Bülent Do we need blood cultures for the management of aspiration pneumonia?. Erciyes Tıp Dergisi, vol.32, no.4, 2010, ss.241 - 246. |
| AMA | Metan G,BOZKURT İ,YILDIZ O,Alp E,AYGEN B,SÜMERKAN B Do we need blood cultures for the management of aspiration pneumonia?. Erciyes Tıp Dergisi. 2010; 32(4): 241 - 246. |
| Vancouver | Metan G,BOZKURT İ,YILDIZ O,Alp E,AYGEN B,SÜMERKAN B Do we need blood cultures for the management of aspiration pneumonia?. Erciyes Tıp Dergisi. 2010; 32(4): 241 - 246. |
| IEEE | Metan G,BOZKURT İ,YILDIZ O,Alp E,AYGEN B,SÜMERKAN B "Do we need blood cultures for the management of aspiration pneumonia?." Erciyes Tıp Dergisi, 32, ss.241 - 246, 2010. |
| ISNAD | Metan, Gökhan vd. "Do we need blood cultures for the management of aspiration pneumonia?". Erciyes Tıp Dergisi 32/4 (2010), 241-246. |
