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Predictors of positive blood cultures in critically ill patients: a retrospective evaluation

AIM: To identify predictors of bacteremia in critically ill patients, to evaluate the impact of blood cultures on the outcome, and to define conditions for breakthrough bacteremia despite concurrent antibiotic treatment. METHODS: A descriptive retrospective study was performed over a two-year period...

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Autores principales: Previsdomini, Marco, Gini, Massimiliano, Cerutti, Bernard, Dolina, Marisa, Perren, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Croatian Medical Schools 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284177/
https://www.ncbi.nlm.nih.gov/pubmed/22351576
http://dx.doi.org/10.3325/cmj.2012.53.30
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author Previsdomini, Marco
Gini, Massimiliano
Cerutti, Bernard
Dolina, Marisa
Perren, Andreas
author_facet Previsdomini, Marco
Gini, Massimiliano
Cerutti, Bernard
Dolina, Marisa
Perren, Andreas
author_sort Previsdomini, Marco
collection PubMed
description AIM: To identify predictors of bacteremia in critically ill patients, to evaluate the impact of blood cultures on the outcome, and to define conditions for breakthrough bacteremia despite concurrent antibiotic treatment. METHODS: A descriptive retrospective study was performed over a two-year period (2007-2008) in the medico-surgical Intensive Care Unit (ICU) of the San Giovanni Hospital in Bellinzona, Switzerland. RESULTS: Forty-five out of 231 patients (19.5%) had positive blood cultures. Predictors of positive blood cultures were elevated procalcitonin levels (>2 µg/L, P < 0.001), higher severity scores (Simplified Acute Physiology Score II>43, P = 0.014; Sequential Organ Failure Assessment >4.0, P < 0.001), and liver failure (P = 0.028). Patients with bacteremia had longer hospital stays (31 vs 21 days, P = 0.058), but their mortality was not different from patients without bacteremia. Fever (t > 38.5°C) only showed a trend toward a higher rate of blood culture positivity (P = 0.053). The rate of positive blood cultures was not affected by concurrent antibiotic therapy. CONCLUSIONS: The prediction of positive blood culture results still remains a very difficult task. In our analysis, blood cultures were positive in 20% of ICU patients whose blood was cultured, and positive findings increased with elevated procalcitonin levels, liver failure, and higher severity scores. Blood cultures drawn >4 days after the start of antibiotic therapy and >5 days after surgery could detect pathogens responsible for a new infection complication.
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spelling pubmed-32841772012-02-22 Predictors of positive blood cultures in critically ill patients: a retrospective evaluation Previsdomini, Marco Gini, Massimiliano Cerutti, Bernard Dolina, Marisa Perren, Andreas Croat Med J Clinical Science AIM: To identify predictors of bacteremia in critically ill patients, to evaluate the impact of blood cultures on the outcome, and to define conditions for breakthrough bacteremia despite concurrent antibiotic treatment. METHODS: A descriptive retrospective study was performed over a two-year period (2007-2008) in the medico-surgical Intensive Care Unit (ICU) of the San Giovanni Hospital in Bellinzona, Switzerland. RESULTS: Forty-five out of 231 patients (19.5%) had positive blood cultures. Predictors of positive blood cultures were elevated procalcitonin levels (>2 µg/L, P < 0.001), higher severity scores (Simplified Acute Physiology Score II>43, P = 0.014; Sequential Organ Failure Assessment >4.0, P < 0.001), and liver failure (P = 0.028). Patients with bacteremia had longer hospital stays (31 vs 21 days, P = 0.058), but their mortality was not different from patients without bacteremia. Fever (t > 38.5°C) only showed a trend toward a higher rate of blood culture positivity (P = 0.053). The rate of positive blood cultures was not affected by concurrent antibiotic therapy. CONCLUSIONS: The prediction of positive blood culture results still remains a very difficult task. In our analysis, blood cultures were positive in 20% of ICU patients whose blood was cultured, and positive findings increased with elevated procalcitonin levels, liver failure, and higher severity scores. Blood cultures drawn >4 days after the start of antibiotic therapy and >5 days after surgery could detect pathogens responsible for a new infection complication. Croatian Medical Schools 2012-02 /pmc/articles/PMC3284177/ /pubmed/22351576 http://dx.doi.org/10.3325/cmj.2012.53.30 Text en Copyright © 2012 by the Croatian Medical Journal. All rights reserved. http://creativecommons.org/licenses/by/2.5/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Science
Previsdomini, Marco
Gini, Massimiliano
Cerutti, Bernard
Dolina, Marisa
Perren, Andreas
Predictors of positive blood cultures in critically ill patients: a retrospective evaluation
title Predictors of positive blood cultures in critically ill patients: a retrospective evaluation
title_full Predictors of positive blood cultures in critically ill patients: a retrospective evaluation
title_fullStr Predictors of positive blood cultures in critically ill patients: a retrospective evaluation
title_full_unstemmed Predictors of positive blood cultures in critically ill patients: a retrospective evaluation
title_short Predictors of positive blood cultures in critically ill patients: a retrospective evaluation
title_sort predictors of positive blood cultures in critically ill patients: a retrospective evaluation
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284177/
https://www.ncbi.nlm.nih.gov/pubmed/22351576
http://dx.doi.org/10.3325/cmj.2012.53.30
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