Examination of influential factors on mortality in patients with culture positive hematology

INTRODUCTION AND PURPOSE: It was aimed to determine the antibiotic resistance rates, simultaneous crp, pct, complete blood count parameters, the last treatment they received, and the use of g-csf in patients with hematological diagnosis and culture growth in the service follow-up, and to investigate the effects of these on mortality. METHOD: Patients who were hospitalized in the Hematology service between January 2015 and January 2019, whose microbiological cultures were grown and whose simultaneous procalcitonin (Pct) measurement was taken, were included in the study retrospectively. 128 male and 116 female patients who met the criteria were identified and included in the study. The demographic information of the patients and their crp, pct, wbc, plt, lym, hb values were recorded. The cultures of the patients were examined for growth. In patients with growth in culture, the culture in which the growth occurred and the type of the reproducing agent were recorded. Antibiotic resistance was recorded. Data were analyzed with the IBM SPSS Statistics 20.0 program. RESULTS: In our study, 113 (47.3%) of 239 cases diagnosed with hematological disease were female and 126 (52.7%) were male, and the female/male ratio was found to be approximately 0.9. The mean age of the patients was 68.13±13.60 years and the median age was 77. Mortality rate among the cases was 35.5% and 85 patients died. 88 (36.8%) lymphomas, 50 (20.9%) leukemias, 41 (17.2%) multiple myeloma, 18 (7.5%) MDS of the patients diagnosed with hematological disease . Eighty (33.5%) of the cultures were gram (+), 152 (63.6%) were gram (-), six (2.5%) were candida, and one (0.4%) was mycobacterium. CONCLUSION: There are multiple factors that affect the mortality of patients in the hematology service. The most important of these is that patients with immunosuppression reach the bacteremia picture more easily and this picture lasts longer. The bacteremia picture of these patients with repeated antibiotic use is difficult to manage. For this reason, antibiotic resistance and susceptibility status should be revealed in each clinic according to the results of the antibiogram. Thus, rational use of antibiotics will be ensured. The pct and plt values of patients with growth in their cultures provide supportive information in terms of mortality. Key words: Antibiogram, Hematology, Thrombocytopenia, Infection