Blood culture Gram stain and clinical categorization based empirical antimicrobial therapy of bloodstream infection

Hautala, Timo; Syrjälä, Hannu; Lehtinen, Ville; Kauma, Heikki; Kauppila, Jaana; Kujala, Pekka; Pietarinen, Ilmo; Ylipalosaari, Pekka; Koskela, Markku

doi:10.1016/j.ijantimicag.2004.11.015

Cited by 26 publications

(25 citation statements)

References 16 publications

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“…S. epidermidis, S. aureus and E. coli are the main positive bacteria. Our results are consistent with the positive rate and bacterial distribution of PDAP in recent years according to the results of the studies conducted in other PD centers [13,19], and these results are far below the 80% positive rate suggested by the ISPD guideline. We usually initiate empirical treatment with broad spectrum antibiotics before confirming the pathogenic bacteria in clinical practice.…”

Section: Discussionsupporting

confidence: 92%

The Application Analysis of Multiplex Real-Time Polymerase Chain Reaction Assays for Detection of Pathogenic Bacterium in Peritoneal Dialysis-Associated Peritonitis

Yang

2019

Blood Purif

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Background/Aims: To estimate the clinical value of bacterial detection in peritoneal dialysis-associated peritonitis (PDAP) by multiplex real-time polymerase chain reaction (RT-PCR). This study was undertaken to evaluate multiplex RT-PCR for identifying clinically significant bacteria in PDAP. Methods: Seventy peritoneal dialysate specimens were collected and traditional bacterial culture and universal primer RT-PCR detection of the bacterial were used. Results: The positive rate of traditional culture method was 65.71% (46/70) and that of universal primer RT-PCR was 81.42% (57/70). For 6 clinical commonly pathogenic bacteria, multiplex, and monoplex RT-PCR all detected 38 positive ones within the 57 specimens that were detected positive by universal primer RT-PCR. The results of the 2 methods were completely identical. Detecting bacteria by universal primer PCR and Monoplex RT-PCR needs 4–5 and 6–9 h, respectively, while multiplex RT-PCR needs less than 3 h. Conclusion: Our results demonstrated that the multiplex RT-PCR can detect several kinds of bacteria simultaneously and it is also more practical and convenient than monoplex RT-PCR.

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Section: Discussionsupporting

confidence: 92%

The Application Analysis of Multiplex Real-Time Polymerase Chain Reaction Assays for Detection of Pathogenic Bacterium in Peritoneal Dialysis-Associated Peritonitis

Yang

2019

Blood Purif

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“…Most therapy interventions with regard to bloodstream infections are made at the time of phlebotomy and on the basis of notification of Gram stain characteristics rather than on the basis of microbiological identification or susceptibility determination (7,15). It is questionable whether clinicians will routinely wait 4 hours until FISH results are available before a start or change of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Faster Identification of Pathogens in Positive Blood Cultures by Fluorescence In Situ Hybridization in Routine Practice

et al. 2006

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“…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.…”

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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

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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.

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Blood culture Gram stain and clinical categorization based empirical antimicrobial therapy of bloodstream infection

Cited by 26 publications

References 16 publications

The Application Analysis of Multiplex Real-Time Polymerase Chain Reaction Assays for Detection of Pathogenic Bacterium in Peritoneal Dialysis-Associated Peritonitis

The Application Analysis of Multiplex Real-Time Polymerase Chain Reaction Assays for Detection of Pathogenic Bacterium in Peritoneal Dialysis-Associated Peritonitis

Faster Identification of Pathogens in Positive Blood Cultures by Fluorescence In Situ Hybridization in Routine Practice

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

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