الفهرس 
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Abstract
Blood stream infection is one of the most common clinical problems confronting
physicians worldwide. It usually implicates a disseminated infectious process associated with
increased morbidity, mortality, and costs.
Traditionally, BSI has been divided into community and nosocomial episodes. A
proposal was made to further subdivide community-onset BSI into healthcare-associated
Discussion
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(HCA) episodes for patients with significant recent healthcare contact and procedures, and
strictly community-acquired (CA) episodes for patients without.
The spectrum of organisms causing bacteremia has changed over the years. Infections
due to Gram-positive organisms have become increasingly frequent.So, prompt, accurate
detection and identification of bloodstream pathogens are essential for optimal management
of patients.
A total of 45specimens were collected from Beni-Suef University Hospital in six
months period .They were divided into 2 groups:-
group (1) 25 pediatric specimens were collected on isolator 1.5 blood culture system
and on manual pediatric blood culture bottles to compare results. Specimens on isolator had
been processed as soon as they were received in the laboratory.Specimens were divided
evenly among the primary isolation media.Specimens on manual pediatric blood culture
bottles were incubated aerobically at 37°C for 7 days. The bottles were examined daily for
evidence of bacterial growth. Subcultures were done on blood agar, chocolate agar,
Macconkey’s agar daily for 7 days before reporting blood cultures as negative.
group (2) 20 adult specimens were collected on signal blood culture system.After
incubation,identification was done using blood agar, chocolate agar, Macconkey agar and
manual biochemical tests. Antibiotic sensitivity testing was done using the disk-diffusion
method on Mueller-Hinton Agar.
The observed blood culture positivity rate was 33.3% andchildren prevalence of BSI
was 36%.Gram-positive bacteria represented66.7% of BSI while gram-negative bacteria
represented33.3%. Among the bacterial pathogens, the most common bacterial isolates
were: coagulase negative Staphylococci (CoNS)(33.3%), Staphylococcus aureus
(S.aureus) (26.7%), Acintobacter(20%), Klebsiella spp.(6.7%), Pseudomonas aeruginosa (P.
aeruginosa) (6.7%) and Corynebacterium species(6.7%).Three cases (75%) of the four S.
a u r e u s i s o l a t e s w e r e d i a g n o s e d a s M R S A .
Discussion
91
Isolator blood culture is fast and more sensitive in predicting bacteremia than manual
blood culture bottle.
We found that (11/15)73.3% hospital acquired, (3/15)20% community acquired
and(1/15) 6.7% health care associated BSI.And the most frequent source of nosocomial
bacteremia was intravenous catheter, accounting for almost(8/11) 72.7% of the hospital
acquired cases and for almost (9/15) 60% of all episodes.