Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis

<p>Abstract</p> <p>Background</p> <p>The identification of clinical factors associated with negative blood cultures could help to avoid unnecessary blood cultures. C-reactive protein (CRP) is a well-established inflammation marker commonly used in the management of medi...

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Main Authors: Salzberger Bernd, Linde Hans-Jörg, Henke Christine, Ehrenstein Vera, Ehrenstein Boris P, Schölmerich Jürgen, Glück Thomas
Format: Article
Language:English
Published: BMC 2008-10-01
Series:BMC Infectious Diseases
Online Access:http://www.biomedcentral.com/1471-2334/8/148
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author Salzberger Bernd
Linde Hans-Jörg
Henke Christine
Ehrenstein Vera
Ehrenstein Boris P
Schölmerich Jürgen
Glück Thomas
author_facet Salzberger Bernd
Linde Hans-Jörg
Henke Christine
Ehrenstein Vera
Ehrenstein Boris P
Schölmerich Jürgen
Glück Thomas
author_sort Salzberger Bernd
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>The identification of clinical factors associated with negative blood cultures could help to avoid unnecessary blood cultures. C-reactive protein (CRP) is a well-established inflammation marker commonly used in the management of medical inpatients.</p> <p>Methods</p> <p>We studied the association of clinical factors, CRP levels and changes of CRP documented prior to blood culture draws with the absence of bacteremia for hospitalized medical patients.</p> <p>Results</p> <p>In the retrospective analysis of 710 blood cultures obtained from 310 medical inpatients of non-intensive-care wards during one year (admission blood cultures obtained in the emergency room were excluded), the following retrospectively available factors were the only independent predictors of blood cultures negative for obligate pathogens: a good clinical condition represented by the lowest of three general nursing categories (OR 4.2, 95% CI 1.8 – 9.5), a CRP rise > 50 mg/L documented before the blood culture draw (OR 2.0 95% CI 1.8–9.5) and any antibiotic treatment in the previous seven days (OR 2.0, 95% CI 1.1–3.5).</p> <p>Conclusion</p> <p>Including the general clinical condition, antibiotic pre-treatment and a substantial rise of CRP into the decision, whether or not to obtain blood cultures from medical inpatients with a suspected infection, could improve the diagnostic yield.</p>
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spelling doaj.art-51e09a0849b842138204fe5404e779ac2022-12-22T02:48:33ZengBMCBMC Infectious Diseases1471-23342008-10-018114810.1186/1471-2334-8-148Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysisSalzberger BerndLinde Hans-JörgHenke ChristineEhrenstein VeraEhrenstein Boris PSchölmerich JürgenGlück Thomas<p>Abstract</p> <p>Background</p> <p>The identification of clinical factors associated with negative blood cultures could help to avoid unnecessary blood cultures. C-reactive protein (CRP) is a well-established inflammation marker commonly used in the management of medical inpatients.</p> <p>Methods</p> <p>We studied the association of clinical factors, CRP levels and changes of CRP documented prior to blood culture draws with the absence of bacteremia for hospitalized medical patients.</p> <p>Results</p> <p>In the retrospective analysis of 710 blood cultures obtained from 310 medical inpatients of non-intensive-care wards during one year (admission blood cultures obtained in the emergency room were excluded), the following retrospectively available factors were the only independent predictors of blood cultures negative for obligate pathogens: a good clinical condition represented by the lowest of three general nursing categories (OR 4.2, 95% CI 1.8 – 9.5), a CRP rise > 50 mg/L documented before the blood culture draw (OR 2.0 95% CI 1.8–9.5) and any antibiotic treatment in the previous seven days (OR 2.0, 95% CI 1.1–3.5).</p> <p>Conclusion</p> <p>Including the general clinical condition, antibiotic pre-treatment and a substantial rise of CRP into the decision, whether or not to obtain blood cultures from medical inpatients with a suspected infection, could improve the diagnostic yield.</p>http://www.biomedcentral.com/1471-2334/8/148
spellingShingle Salzberger Bernd
Linde Hans-Jörg
Henke Christine
Ehrenstein Vera
Ehrenstein Boris P
Schölmerich Jürgen
Glück Thomas
Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis
BMC Infectious Diseases
title Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis
title_full Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis
title_fullStr Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis
title_full_unstemmed Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis
title_short Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis
title_sort risk factors for negative blood cultures in adult medical inpatients a retrospective analysis
url http://www.biomedcentral.com/1471-2334/8/148
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