Predicting Bacteremia in Hospitalized Patients

Bates, David W.; Cook, E. Francis; Goldman, L; Lee, T H

doi:10.7326/0003-4819-113-7-495

Cited by 251 publications

(188 citation statements)

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“…Several reasons that may explain a false negative result in a blood culture, including prior antibiotic treatment that the patient receives when the sample is taken, the time interval between sampling, skin disinfection methods used before the culture is drawn, volume of the sample drawn and laboratory methods.The need to improve the sensitivity of the test while avoiding false positive results is discussed in the literature in different contexts in the non-surgical patients-emergency departments (Shapiro et al, 2008), hospitalization wards (Coburn et al, 2012;David et al, 1990) and ICU (Shafazand and Weinacker, 2002).…”

Section: Discussionmentioning

confidence: 99%

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

Segal¹

2013

American Journal of Infectious Diseases

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During the first six months of operating a new Internal-medicine ward in a tertiary hospital, a prospective survey, tracking both patient and environment bacteriological samples taken, was conducted. The motive behind the study was to establish the pattern in which environmental colonization is transmitted to the hospitalized patients and vice versa, thus defining the nosocomial pathogens that are typical to the ward. That information can be used to guide empirical antibiotic treatment. Patient sampling was done on clinical grounds whereas environmental cultures were systematically acquired from different surfaces around the ward. 6-months' results analysis suggest that clinically guided culture rates were tightly associated with volume of patients admitted, with no such association demonstrated between volume of cultures taken and rate of positive results, except for urine cultures. Regarding environmental sampling, we demonstrated no benefit in taking empirical, surface samples for common nosocomial pathogens. Our findings could further improve future resources allocation with regard to infection control and clinical bacteriology routines in newly established internal medicine wards.

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Section: Discussionmentioning

confidence: 99%

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

Segal¹

2013

American Journal of Infectious Diseases

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“…Any properly measured temperature reading is acted on, whether measured in the clinic or at home. Any reports of fevers associated with shaking chills or rigors should potentially prompt a more aggressive approach to investigation and treatment based on adult studies and studies of children with fever and neutropenia (2,3). While no directly relevant paediatric studies exist, studies in these related populations show that the relative risk for bacteremia in patients with chills is three to 12 times that of patients without chills.…”

Section: What Constitutes a Fever?mentioning

confidence: 99%

Clinical management of fever in children younger than three years of age

Pusic¹

2007

Paediatrics &Amp; Child Health

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MV Pusic. Clinical management of fever in children younger than three years of age. Paediatr Child Health 2007;12(6):469-472.The clinical management of febrile children continues to evolve, especially in the light of vaccines against Haemophilus influenzae type B and more recently, Streptococcus pneumoniae. These vaccines have decreased the risk of serious bacterial illness in most children, allowing for a more selective approach to investigation and empirical treatment. However, children younger than three months of age still require an aggressive approach to investigation and careful follow-up. Certain laboratory criteria can allow safe management of even young infants on an outpatient basis. The present article outlines an age-based approach to investigation and management of children with fever.Key Words: Bacteremia; Fever; Meningitis; Occult bacteremia; Urinary tract infection La prise en charge clinique de la fièvre chez les enfants de moins de trois ans La prise en charge clinique des enfants fébriles continue d'évoluer, notamment depuis l'adoption des vaccins contre l'Haemophilus influenzae de type B et, plus récemment, contre le Streptococcus pneumoniae. Ces vaccins réduisent le risque de maladie bactérienne grave chez la plupart des enfants, ce qui permet d'adopter une approche plus sélective des explorations et du traitement empirique. Toutefois, il faut toujours privilégier une approche plus musclée des explorations et un suivi attentif auprès des enfants de moins de trois mois. Certains critères de laboratoire permettent la prise en charge sécuritaire des nourrissons très jeunes en consultations externes. Le présent article propose une approche adaptée à l'âge des explorations et de la prise en charge des enfants fébriles.

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“…[7][8][9][10][11] False-positive cultures may lead to the use of inappropriate or unnecessary antibiotics, additional testing and consultation, and prolonged hospitalizations that increase patient care costs. 9,12 Nursing staff caring for patients are generally able to assess oral intake, general clinical state, and care requirements. Moreover, the nursing staff are often able to identify problems with patients before physicians.…”

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confidence: 99%

Predicting bacteremia based on nurse‐assessed food consumption at the time of blood culture

Komatsu

Onda

Murayama

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:Bacteremia and its complications are important causes of morbidity and mortality in hospitalized patients. However, the yield of blood cultures is relatively low, with many false‐positive results from bacterial contamination.METHODS:We investigated the relationship between patient food consumption and the presence of bacteremia. This was an observational analysis of a cohort of 1179 patients who underwent blood culture analysis between January 2005 and December 2009. Patients with anorexia‐inducing conditions, such as gastrointestinal illness and malignant disease treated with chemotherapy, were excluded. Food consumption was rated by nurses as the percentage of food consumed during the meal preceding the blood culture. Groupings were as follows: low consumption (<50%), moderate (>50% to <80%), and high (>80%).RESULTS:Low consumption was observed in 39.8% of patients, moderate in 17.8%, and high in 41.6%. The average body temperature was 38.1 ± 1.1°C. Bacteremia was present in 18.5%, 3.9%, and 1.4% of patients in the low, moderate, and high food consumption groups, respectively. The negative predictive value was 98.3%, suggesting that bacteremia is very unlikely in the setting of good food intake.CONCLUSION:Bacteremia is an unlikely occurrence in hospitalized patients who maintain adequate food consumption at the time of blood culture. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine

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Predicting Bacteremia in Hospitalized Patients

Cited by 251 publications

References 10 publications

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

Clinical management of fever in children younger than three years of age

Predicting bacteremia based on nurse‐assessed food consumption at the time of blood culture

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Predicting Bacteremia in Hospitalized Patients

Cited by 251 publications

References 10 publications

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

Clinical management of fever in children younger than three years of age

Predicting bacteremia based on nurse‐assessed food consumption at the time of blood culture

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The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL