The impact of the first notification of positive blood cultures on antibiotic therapy

Schønheyder, Henrik Carl; Højbjerg, Tove

doi:10.1111/j.1699-0463.1995.tb01077.x

Cited by 58 publications

(38 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with pneumococcal bacteremia were identified in the microbiological County Bacteremia Registry, which is described in detail elsewhere (15). The registry is maintained by the Department of Clinical Microbiology at Aalborg University Hospital, which provides diagnostic bacteriology for the entire county.…”

Section: Research Design and Methods -The Study Was Conducted During mentioning

confidence: 99%

Diabetes and Outcome of Community-Acquired Pneumococcal Bacteremia

et al. 2004

View full text Add to dashboard Cite

OBJECTIVE -Patients with diabetes may carry a higher case fatality of invasive pneumococcal infection compared with nondiabetic patients due to decreased immunity, risk of metabolic derangement, or angiopathy. We conducted a population-based cohort study to assess the impact of diabetes on mortality within 90 days in patients with pneumococcal bacteremia.RESEARCH DESIGN AND METHODS -All patients with community-acquired pneumococcal bacteremia in North Jutland County, Denmark, from January 1992 to December 2001 were retrieved from the County Bacteremia Registry. Using civil registry numbers, patients with diabetes were identified by record linkage with the County Prescription Database (for antidiabetic drugs) and the County Hospital Discharge Registry. Mortality within 90 days was determined through the Central Population Registry. Mortality rates were compared for diabetic and nondiabetic patients and adjusted for sex, age, and comorbidity.RESULTS -Among 628 patients aged Ͼ15 years with community-acquired pneumococcal bacteremia, 63 (10.0%) had diabetes. The diabetic patients were slightly older (median age 71.7 years) than the nondiabetic patients (67.0 years), and the proportion of patients with comorbidity was higher in the diabetic group (59 vs. 46%). Mortality in diabetic patients compared with nondiabetic patients was 11.1 vs. 16.5% after 30 days and 16.0 vs. 19.5% after 90 days, respectively. After adjustment for sex, age, and comorbidity, the mortality rate ratio for diabetic patients was 0.6 (95% CI 0.3-1.2) compared with the nondiabetic patients.CONCLUSIONS -Diabetic patients with community-acquired pneumococcal bacteremia appear not to have a higher case fatality than nondiabetic patients. Diabetes Care 27:70 -76, 2004P neumococcal bacteremia is a lifethreatening disease, with in-hospital case fatality estimated at 12-36% (1-3). Advanced age and comorbidity have been associated with fatal outcome. Currently, the prevalence of type 2 diabetes is rising rapidly in many countries due to population aging and increasing prevalence of obesity (4). Patients with diabetes may carry a higher case fatality of invasive pneumococcal disease than nondiabetic patients (5,6) due to risk of metabolic derangement caused by severe infection per se (7), decreased immunity (8), generally decreased tissue oxygenation, or pulmonary microangiopathic changes (9). Moreover, diabetes is associated with a high prevalence of adverse prognostic factors for pneumococcal bacteremia, including old age and comorbidity.Data are sparse concerning the outcome of invasive pneumococcal infection in patients with diabetes (10). Previous case series of pneumococcal bacteremia (1,2,11-14) have been hampered by small numbers of diabetic patients, cohorts from specialized hospitals, or lack of follow-up after hospital discharge. In the present population-based cohort study, we examined whether patients with diabetes suffer from a higher case fatality within 90 days after an episode of community-acquired pneumococcal bacteremia compared with pa...

show abstract

Section: Research Design and Methods -The Study Was Conducted During mentioning

confidence: 99%

Diabetes and Outcome of Community-Acquired Pneumococcal Bacteremia

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that timeliness of detecting bloodstream pathogens improves antimicrobial therapy, reduces costs, and decreases length of stay and patient mortality. [3][4][5][6][7][9][10][11] Timeliness and accuracy of preliminary blood culture results represent 2 important, evidence-based quality indicators that are closely linked to clinical outcomes.…”

Section: Commentmentioning

confidence: 99%

“…Faster results reporting has been shown to be associated with lower mortality, 3 especially when combined with clinical consultation. 4,5 Other benefits of rapid reporting include improved selection of antimicrobial therapy, [6][7][8][9] lower overall health care costs, 10 and reduced length of stay. 8,11 Timely detection of bacteremia also facilitates initiation of rapid, direct methods for early identification and susceptibility testing.…”

mentioning

confidence: 99%

Timeliness and Accuracy of Reporting Preliminary Blood Culture Results: A College of American Pathologists Q-Probes Study of 65 Institutions

Schifman

Meier

Souers

2015

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Context.-The speed and accuracy of preliminary blood culture reports impacts patient management and outcomes.Objective.-To evaluate the accuracy and timeliness of preliminary blood culture results among multiple laboratories.Design.-Q-Probes participants collected turnaround time (TAT) data on preliminary Gram stains, compared accuracy of up to 100 preliminary to final culture Gram stain results, and described blood culture laboratory practices.Results.-Sixty-four laboratories and 5031 blood cultures were evaluated. All participants used continuously monitoring blood culture systems. Median TAT from initial growth detection to notification of results was 45 minutes, with the longest component being preparation of Gram stains (median time ¼ 25 minutes). Participants (N ¼ 40) reporting a continuous schedule for processing blood cultures had significantly lower overall TAT (median ¼ 37 minutes) compared with 15 participants with intermittent processing schedules (median ¼ 124 minutes), P ¼ .003. Time to complete Gram stain processing was lower (median time ¼ 21 minutes) for 39 participants using continuous processing schedule compared with 14 others (median time ¼ 67 minutes), P ¼ .03. Goals for total TAT were used by 27 of 56 participants (48.2%). Having goals did not significantly affect TAT. A total of 4962 of 5021 Gram stain results (98.8%) agreed with final culture results. The highest discrepancy rates occurred among gram-positive bacilli (20 of 335; 6.0%) and mixed cultures (22 of 106; 20.8%).Conclusions.-This study provides benchmarks for assessing blood culture quality performance. Timeliness and accuracy of preliminary blood culture reports were excellent. However, nearly one-third of laboratories did not process blood cultures continuously. This significantly prolonged reporting results, which could affect patient outcomes.

show abstract

“…This was done through linkage to the County Bacteremia Research Database (21), which stores prospectively collected data on all blood cultures, as well as bacteriological and clinical data on all bacteremia episodes from 1997 through 2003. We considered only the first episode of bacteremia during the hospitalization for pneumonia.…”

Section: Pneumonia Outcomementioning

confidence: 99%

Type 2 Diabetes and Pneumonia Outcomes

et al. 2007

View full text Add to dashboard Cite

OBJECTIVE -We sought to examine whether type 2 diabetes increases risk of death and complications following pneumonia and to assess the prognostic value of admission hyperglycemia.RESEARCH DESIGN AND METHODS -This was a population-based cohort study of adults with a first-time hospitalization for pneumonia between 1997 and 2004 (n ϭ 29,900) in northern Denmark. Information on diabetes, comorbidity, laboratory findings, pulmonary complications, and bacteremia was obtained from medical databases. We used regression to compute adjusted relative risks of pulmonary complications, bacteremia, and mortality rate ratios (MRRs) within 90 days following hospitalization among patients with and without type 2 diabetes. The prognostic impact of admission hyperglycemia was studied in a subcohort (n ϭ 13,574).RESULTS -In total, 2,931 (9.8%) pneumonia patients had type 2 diabetes. Mortality among diabetic patients was greater than that among other patients: 19.9 vs. 15.1% after 30 days and 27.0 vs. 21.6% after 90 days, respectively, corresponding to adjusted 30-and 90-day MRRs of 1.16 (95% CI 1.07-1.27) and 1.10 (1.02-1.18). Presence of type 2 diabetes did not predict pulmonary complications or bacteremia. Adjustment for hyperglycemia attenuated the association between type 2 diabetes and mortality. High glucose level on admission was a predictor of death among patients with diabetes and more so among those without diagnosed diabetes: adjusted 30-day MRRs for glucose level Ն14 mmol/l were 1.46 (1.01-2.12) and 1.91 (1.40 -2.61), respectively. CONCLUSIONS -Type 2 diabetes and admission hyperglycemia predict increased pneumonia-related mortality. Diabetes Care 30:2251-2257, 2007M ortality among adults hospitalized with community-acquired pneumonia (CAP) ranges from 6 to 14% (1). Advanced age and comorbidity are associated with increased mortality in these patients (2-4). Given the hyperglycemia, decreased immunity, impaired lung function, and chronic complications, such as renal failure, heart disease, and pulmonary microangiopathy, associated with diabetes (5), it is plausible that diabetes may predict increased severity of pneumonia. However, results of recent observational studies and a meta-analysis of pneumonia-related mortality, based on pre-1996 research, were inconsistent (6 -10). The discrepancies could stem from the use of clinic-based cohorts, confounding, or incomplete follow-up. Better diagnostic surveillance of diabetic patients may result in lower-than-expected mortality from pneumonia. Most studies lack data on pneumonia severity at hospitalization in diabetic versus nondiabetic patients (6,8 -10), whereas claims that diabetic pneumonia patients have an increased risk of developing bacteremia (5,11) are questionable because data on availability of blood cultures are often absent. Evidence regarding pulmonary complications in diabetic patients with pneumonia is scant (5,7), as are data on the prognostic value of acute hyperglycemia for diabetic patients with pneumonia (10).As prevalences of diabetes (12) and pneumon...

show abstract

The impact of the first notification of positive blood cultures on antibiotic therapy

Cited by 58 publications

References 16 publications

Diabetes and Outcome of Community-Acquired Pneumococcal Bacteremia

Diabetes and Outcome of Community-Acquired Pneumococcal Bacteremia

Timeliness and Accuracy of Reporting Preliminary Blood Culture Results: A College of American Pathologists Q-Probes Study of 65 Institutions

Type 2 Diabetes and Pneumonia Outcomes

Contact Info

Product

Resources

About