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Diagnostics of the blood cultures from the departments of internal medicine in Nemocnice Tábor, a.s.
SMRŽOVÁ, Kamila
The thesis describes blood culture testing at internal medicine departments of Nemocnice Tábor, a.s. (Tábor Hospital). The theoretical part presents the most important terms related to infections of the bloodstream and sepsis. EARS-Net, an important European project is also mentioned. The practical part describes blood culture laboratory process in all phases (preanalytical, analytical and post-analytical) including the steps taken when a sample is positive. Furthermore, the study evaluates data on blood cultures done at internal medicine departments of Nemocnice Tábor, a.s. in 2018, determining the incidence of gram-negative bacteria in positive samples and seeking to describe the differences between community and hospitalised patient groups. Finally, the study also gives an overview of antibiotic resistance in the most commonly detected gram-negative rods including a comparison to EARS-Net data (mean value for internal medicine departments in the Czech Republic). In total, 527 blood culture vials were tested as positive in 2018. A total of 267 positive vials were analysed further after the removal of duplicities and contaminations; a total of 97 strains of gram-negative rods were cultured from the vials. The most commonly detected gram-negative bacterial strains found in positive samples included Escherichia coli (48.5%) and Klebsiella pneumoniae (22.7%). Differences between community and hospitalised patient groups were found only for Klebsiella pneumoniae; however, the pathogens spectra in both groups were not distinctively different. In terms of resistance assessment in the two most common bacterial strains, a higher frequency of incidence of Klebsiella pneumoniae strains resistant to third generation cephalosporins and ciprofloxacin is alarming, also in comparison to EARS-Net data (mean value for internal medicine departments in the Czech Republic).
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