Keywords
Abstract
Purpose of study
Determine the frequency of detection of patients with bloodstream infections (BSI) with applying systemic inflammatory response syndrome (SIRS) criteria, and analyze the clinical characteristics of patients with suspected BSI.
Methods
In the study were included 1,463 patients hospitalized in various departments according to their primary diagnosis. Indication for study inclusion and hemoculture collection of patients was the detection of at least 2 or more criteria of SIRS (ACCP/SCCM, Atlanta, 1992), in accordance with the protocol of the POP project "Proof-of-principle routine diagnostic project for a Antimicrobial Resistance Surveillance", with technical support from WHO, during the period from 2019-2020.
The obtained results
The largest number of patients (376) was admitted to the intensive care unit, 293 patients each admitted to the pediatric and infectious disease units and 183 patients admitted to the diagnostic units. All characteristic clinical symptoms of SIRS occurred in the examined patients. Hyperthermia was the most common in all age groups - in 47 patients in 74.60±1.08% of cases in the group of patients under one year of age, significantly more frequent in the group of 1-5 years (594), 5-12 years (166), 12-18 and over 18 years (60; 486, respectively P<0.05). Tachycardia was also frequently observed in all age groups - almost in all patients (91.9±0.99%) in the group less than 1 year old, almost equally often in 75±0.66% and 73.90±0.38% of cases in the group 5-12 and over 18 years old, respectively. This symptom was noted in more than 50% of cases in patients in the 1-5 (65%) and 12-18 (84%) age group. Tachypnea and leukocytosis were most frequently observed in patients under 1 year of age (47.62±0.87% and 71.43±1.06%, respectively), whereas in the remaining groups (1-5, 5-12, 12-18, and over 18 years of age), leukocytosis was noted in 63%, 50%, 59%, and 58% of cases, respectively, and tachypnea in 23%, 10%, 19%, and 25%, respectively. A combination of 2 symptoms (hyperthermia and tachycardia), a combination of hyperthermia and leukocytosis in 18.1% of cases, a triad of symptoms tachycardia, hyperthermia and leukocytosis in 23.9% of cases was the most common (41.5%) of the criteria for SSRIs. Also often enough (6.8%) were observed 4 symptoms hyperthermia, tachycardia, tachypnoea and leukocytosis.
Conclusions
The most frequent localization of infection in BSI was the upper respiratory tract, lower respiratory tract infections were detected twice as often. Predominantly, regardless of the localization of infection, a combination of the criteria for SIRS of two symptoms was observed. Irrespective of the localization of infection, all patients had fever in various combinations, most frequently with tachycardia (26.8%) and leukocytosis (26.2%).