Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship
Objective: To assess whether 48-h negative blood culture (BC) bottles are still negative at the classic 120-h incubation endpoint and whether 48 h might be the time to make antimicrobial therapy decisions. Methods: Data from the first collected bottles from bloodstream infection (BSI) episodes of si...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024038805 |
| _version_ | 1797224233254780928 |
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| author | Giulia Menchinelli Alice Oliveti Barbara Fiori Tiziana D'Inzeo Teresa Spanu Rita Murri Massimo Fantoni Maurizio Sanguinetti Brunella Posteraro Giulia De Angelis |
| author_facet | Giulia Menchinelli Alice Oliveti Barbara Fiori Tiziana D'Inzeo Teresa Spanu Rita Murri Massimo Fantoni Maurizio Sanguinetti Brunella Posteraro Giulia De Angelis |
| author_sort | Giulia Menchinelli |
| collection | DOAJ |
| description | Objective: To assess whether 48-h negative blood culture (BC) bottles are still negative at the classic 120-h incubation endpoint and whether 48 h might be the time to make antimicrobial therapy decisions. Methods: Data from the first collected bottles from bloodstream infection (BSI) episodes of single patients were retrospectively analyzed. Probabilities of bottles being negative at the classic endpoint were calculated from 0 to 120 h of incubation. Results: Among BC-negative episodes (4018/4901 [82.0%]), most (2097/4018 (52.2%) occurred in medicine patients. At 48 h, probability was 100.0% (95% CI, 99.9–100.0) for all 4018 patients. Of these, 1244 (31.0%) patients remained on antibiotics until 120 h. Excluding 401 (32.2%) patients who received antibiotics for another (non-bloodstream) infection, 843 (67.8%) of 1244 patients could have merited early (48-h) discontinuation of antibiotics. Stopping treatment in these patients would have led to saving 5201 days of access (943 [18.1%] days), watch (3624 [69.7%] days), or reserve (634 [12.2%]) AWaRe groups’ antibiotics, which correspond to 65.6% (5201/7928) of days of administered antibiotics in all 1244 patients. Conclusion: As an early indicator of BC negativity, the 48-h endpoint could reliably support antimicrobial stewardship, but the clinical judgment remains imperative especially when BSI is highly suspected. |
| first_indexed | 2024-04-24T13:49:52Z |
| format | Article |
| id | doaj.art-e5f5d2df33d94d3d89af85a19885d5c4 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-24T13:49:52Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-e5f5d2df33d94d3d89af85a19885d5c42024-04-04T05:06:09ZengElsevierHeliyon2405-84402024-03-01106e27849Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardshipGiulia Menchinelli0Alice Oliveti1Barbara Fiori2Tiziana D'Inzeo3Teresa Spanu4Rita Murri5Massimo Fantoni6Maurizio Sanguinetti7Brunella Posteraro8Giulia De Angelis9Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, ItalyDipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168, Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168, Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168, Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy; Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, 00168, Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy; Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, 00168, Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168, Rome, Italy; Corresponding author. Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Largo Gemelli, 8 00168, Rome, Italy.Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168, Rome, Italy; Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168, Rome, ItalyObjective: To assess whether 48-h negative blood culture (BC) bottles are still negative at the classic 120-h incubation endpoint and whether 48 h might be the time to make antimicrobial therapy decisions. Methods: Data from the first collected bottles from bloodstream infection (BSI) episodes of single patients were retrospectively analyzed. Probabilities of bottles being negative at the classic endpoint were calculated from 0 to 120 h of incubation. Results: Among BC-negative episodes (4018/4901 [82.0%]), most (2097/4018 (52.2%) occurred in medicine patients. At 48 h, probability was 100.0% (95% CI, 99.9–100.0) for all 4018 patients. Of these, 1244 (31.0%) patients remained on antibiotics until 120 h. Excluding 401 (32.2%) patients who received antibiotics for another (non-bloodstream) infection, 843 (67.8%) of 1244 patients could have merited early (48-h) discontinuation of antibiotics. Stopping treatment in these patients would have led to saving 5201 days of access (943 [18.1%] days), watch (3624 [69.7%] days), or reserve (634 [12.2%]) AWaRe groups’ antibiotics, which correspond to 65.6% (5201/7928) of days of administered antibiotics in all 1244 patients. Conclusion: As an early indicator of BC negativity, the 48-h endpoint could reliably support antimicrobial stewardship, but the clinical judgment remains imperative especially when BSI is highly suspected.http://www.sciencedirect.com/science/article/pii/S2405844024038805Antimicrobial stewardshipBloodstream infectionBlood cultureIncubation time |
| spellingShingle | Giulia Menchinelli Alice Oliveti Barbara Fiori Tiziana D'Inzeo Teresa Spanu Rita Murri Massimo Fantoni Maurizio Sanguinetti Brunella Posteraro Giulia De Angelis Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship Heliyon Antimicrobial stewardship Bloodstream infection Blood culture Incubation time |
| title | Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship |
| title_full | Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship |
| title_fullStr | Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship |
| title_full_unstemmed | Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship |
| title_short | Early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship |
| title_sort | early assessment of blood culture negativity as a potential support tool for antimicrobial stewardship |
| topic | Antimicrobial stewardship Bloodstream infection Blood culture Incubation time |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024038805 |
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