Blood culture audits valuable at peripheral hospitals.
Article Type: Editorial
Subject: Infection control (Methods)
Drug resistance (Care and treatment)
Antibiotics (Health aspects)
Antibiotics (Usage)
Pub Date: 04/01/2012
Publication: Name: South African Medical Journal Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 South African Medical Association ISSN: 0256-9574
Issue: Date: April, 2012 Source Volume: 102 Source Issue: 4
Product: SIC Code: 2834 Pharmaceutical preparations
Accession Number: 286392537
Full Text: The auditing of health services has well-established benefits. However, there is little published on the practical monitoring and handling of changes to microbial threats in individual hospitals. There is concern about the rise of multidrug-resistant bacteria, and the roles of healthcare facilities. Appropriate empiric antibiotic guidelines should be based on accurate and up-to-date knowledge of local antibiotic sensitivities. Kenyon and colleagues (3) therefore studied the these trends in blood culture (BC) results at G F Jooste Hospital from 2005 to 2010 using the National Health Laboratory Service (NHLS) Data Warehouse.

The authors investigated the BC contamination rate and changes in the antibiotic sensitivity profiles of selected organisms, and estimated the proportion of infections that were hospital acquired. They observed a high contamination rate with a gratifying reduction by 2010, but concluded that: (i) the contamination rate, though reduced, was unacceptably high; (ii) there was a rising rate of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae (KP) infection, most of which was nosocomially acquired and some of which was likely to have been driven by the widespread use of ceftriaxone; and (iii) the high proportion of multiple resistant Staphylococcus aureus and ESBL-producing KP suggested a failure of basis infection control. The authors describe their interventions to improve this situation.
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