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Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes
BACKGROUND: Recommended management of Staphylococcus aureus bacteremia (SAB) includes follow-up blood culture sets (BCs) to determine the duration of bacteremia. Duration of bacteremia is an important prognostic factor in SAB, and follow-up BCs have a critical role in differentiation of uncomplicate...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047948/ https://www.ncbi.nlm.nih.gov/pubmed/32128336 http://dx.doi.org/10.1093/ofid/ofz494 |
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author | Stewart, James D Graham, Maryza Kotsanas, Despina Woolley, Ian Korman, Tony M |
author_facet | Stewart, James D Graham, Maryza Kotsanas, Despina Woolley, Ian Korman, Tony M |
author_sort | Stewart, James D |
collection | PubMed |
description | BACKGROUND: Recommended management of Staphylococcus aureus bacteremia (SAB) includes follow-up blood culture sets (BCs) to determine the duration of bacteremia. Duration of bacteremia is an important prognostic factor in SAB, and follow-up BCs have a critical role in differentiation of uncomplicated and complicated SAB. However, intermittent negative BCs occur in SAB. Clinical guidelines for SAB management do not specify an approach to follow-up BCs’ collection or define the number of negative BCs required to demonstrate resolution of bacteremia. This study assessed the frequency of intermittent negative BCs in SAB and used these findings to formulate a recommendation for collection of follow-up BCs. METHODS: This retrospective study reviewed 1071 episodes of SAB. Clinical and microbiological data including the duration of bacteremia and the occurrence of intermittent negative BCs (those preceded and followed by positive cultures) were considered. RESULTS: Intermittent bacteremia occurred in 13% (140/1071) of episodes. A single negative BC on days 1–3 had a predictive value of 87%–93% for resolution of bacteremia, although this was improved if all BCs collected within the same day were considered. CONCLUSIONS: Intermittent negative BCs are common in SAB. Given this, we would not recommend accepting a single negative BC as demonstrating resolution of the bacteremia. This is particularly important if a patient is to be classified as having uncomplicated SAB. |
format | Online Article Text |
id | pubmed-7047948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-70479482020-03-03 Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes Stewart, James D Graham, Maryza Kotsanas, Despina Woolley, Ian Korman, Tony M Open Forum Infect Dis Major Articles BACKGROUND: Recommended management of Staphylococcus aureus bacteremia (SAB) includes follow-up blood culture sets (BCs) to determine the duration of bacteremia. Duration of bacteremia is an important prognostic factor in SAB, and follow-up BCs have a critical role in differentiation of uncomplicated and complicated SAB. However, intermittent negative BCs occur in SAB. Clinical guidelines for SAB management do not specify an approach to follow-up BCs’ collection or define the number of negative BCs required to demonstrate resolution of bacteremia. This study assessed the frequency of intermittent negative BCs in SAB and used these findings to formulate a recommendation for collection of follow-up BCs. METHODS: This retrospective study reviewed 1071 episodes of SAB. Clinical and microbiological data including the duration of bacteremia and the occurrence of intermittent negative BCs (those preceded and followed by positive cultures) were considered. RESULTS: Intermittent bacteremia occurred in 13% (140/1071) of episodes. A single negative BC on days 1–3 had a predictive value of 87%–93% for resolution of bacteremia, although this was improved if all BCs collected within the same day were considered. CONCLUSIONS: Intermittent negative BCs are common in SAB. Given this, we would not recommend accepting a single negative BC as demonstrating resolution of the bacteremia. This is particularly important if a patient is to be classified as having uncomplicated SAB. Oxford University Press 2019-11-18 /pmc/articles/PMC7047948/ /pubmed/32128336 http://dx.doi.org/10.1093/ofid/ofz494 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Articles Stewart, James D Graham, Maryza Kotsanas, Despina Woolley, Ian Korman, Tony M Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes |
title | Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes |
title_full | Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes |
title_fullStr | Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes |
title_full_unstemmed | Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes |
title_short | Intermittent Negative Blood Cultures in Staphylococcus aureus Bacteremia; a Retrospective Study of 1071 Episodes |
title_sort | intermittent negative blood cultures in staphylococcus aureus bacteremia; a retrospective study of 1071 episodes |
topic | Major Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047948/ https://www.ncbi.nlm.nih.gov/pubmed/32128336 http://dx.doi.org/10.1093/ofid/ofz494 |
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