Diagnóstico microbiológico de la bacteriemia y la fungemia: hemocultivos y métodos moleculares

Serrano, María Remedio Guna; Larrosa, Nieves; Arriaza, Mercedes Marín; Dı́az, Juan Carlos Rodrı́guez

doi:10.1016/j.eimc.2018.03.005

Cited by 25 publications

(12 citation statements)

References 20 publications

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“…Si bien la técnica de extracción de los HC está bien estandarizada y protocolizada [2,3,6], todavía hay importantes controversias en relación a las indicaciones de cuándo hacerlo [1,13,17]. Comparadas con el resto de pruebas habituales que se realizan en los SU, requieren un mayor tiempo para su obtención, una buena técnica para evitar contaminaciones y carecen de utilidad diagnóstica definitiva inmediata [2,3]. A pesar de ello, la obtención de HC es una práctica creciente en la valoración inicial de los pacientes con sospecha de infección en el SU [1,3].…”

Section: Discussionunclassified

“…Se define como bacteriemia la presencia de bacterias en la sangre que se pone de manifiesto por el aislamiento de éstas en los HC [2]. A pesar de las nuevas técnicas de detección rápida (del ADN del patógeno o por aplicación de espectrometría de masas), los HC permiten el diagnóstico etiológico de la infección, aportan información sobre la sensibilidad del microorganismo aislado y favorecen la optimización del tratamiento antimicrobiano [2][3][4][5].…”

Section: Introductionunclassified

“…La rentabilidad diagnóstica de los HC obtenidos en los SU es muy variable (2-20%) [3], mientras que los considerados "HC contaminantes", aunque sería deseable que fuesen menos del 3% [2,3], en realidad pueden alcanzar tasas muy superiores [6,7]. Además, los HC con aislamiento significativo de los pacientes que son dados de alta (la llamada bacteriemia oculta) suponen del 3-5% de los extraídos en el SU [3,8].…”

Section: Introductionunclassified

“…Además, los HC con aislamiento significativo de los pacientes que son dados de alta (la llamada bacteriemia oculta) suponen del 3-5% de los extraídos en el SU [3,8]. Estos hechos representan verdaderos problemas, al conllevar un incremento de las pruebas diagnósticas realizadas, de la estancia hospitalaria, de los costes y la administración de tratamientos antibióticos innecesarios o, en su caso, altas improcedentes en los casos de "bacteriemias ocultas" [2,3,9,11].…”

Section: Introductionunclassified

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Predictive factors of bacteraemia in the patients seen in emergency departments due to infections

Iqbal‐Mirza¹,

Estévez-González²,

Ávila³

et al. 2020

Rev Esp Quimioter

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Objectives. The aim of the study was to analyze predictive factors of bacteraemia in patients seen in the emergency department (ED) for an episode of infectious disease. Patients and methods. Observational, retrospective and descriptive analytical study of all blood cultures extracted in an ED in adult patients (≥ 18 years) seen in ED due to infectious disease from 1-1-2019 to 1-7-2019. The follow-up was carried out during 30 days. Thirty-eight variables for predicting bacteraemia were assessed. They covered epidemiological, comorbidity, functional, clinical and analytical factors. Univariate and multivariate logistic regression analysis was performed. Results. A total of 1,425 blood cultures were finally enrolled in the study. Of those were considered true bacteremia 179 (12.6 %) and as negative blood cultures 1,246 (87.4 %). Amongst negatives, 1,130 (79.3%) without growth and 116 (8.1%) as contaminants blood cultures. Five variables were significantly associated with true bacteraemia: serum procalcitonin (PCT)

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Section: Discussionunclassified

Section: Introductionunclassified

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Predictive factors of bacteraemia in the patients seen in emergency departments due to infections

Iqbal‐Mirza¹,

Estévez-González²,

Ávila³

et al. 2020

Rev Esp Quimioter

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“…Asimismo, representa la primera causa de muerte y de ingreso en la unidad de cuidados intensivos (UCI) (2-10%) por enfermedad infecciosa desde los SUH [1,2]. Se le atribuye una mortalidad global del 10-14% a los 30 días según la edad y factores de riesgo asociados, entre ellos la coexistencia de bacteriemia que aumenta la mortalidad hasta el 20-25% [1][2][3][4].…”

Section: Introductionunclassified

Usefulness of the 5MPB-Toledo model to predict bacteremia in patients with community-acquired pneumonia in the Emergency Department

Julián-Jiménez

Castillo²,

García-Lamberechts³

et al. 2021

Rev Esp Quimioter

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Objective. To analyse a new risk score to predict bacteremia in the patients with Community-acquired Pneumonia (CAP) in the emergency departments. Patients and methods. Prospective and multicenter observational cohort study of the blood cultures ordered in 74 Spanish emergency departments for patients with CAP seen from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the chosen cut-off for getting the sensitivity, specificity, positive predictive value and negative predictive value. Results. A total of 1,020 blood samples wered cultured. True cases of bacteremia were confirmed in 162 (15.9%). The remaining 858 cultures (84.1%) wered negative. And, 59 (5.8%) were judged to be contaminated. The model´s area under the receiver operating characteristic curve was 0.915 (95% CI, 0.898-0.933). The prognostic performance with a model´s cut-off value of ≥ 5 points achieved 97.5% (95% CI, 95.1-99.9) sensitivity, 73.2% (95% CI, 70.2-76.2) specificity, 40.9% (95% CI, 36.4-45.1) positive predictive value and 99.4% (95% CI, 99.1-99.8) negative predictive value. Conclusion. The 5MPB-Toledo score is useful for predicting bacteremia in the patients with CAP seen in the emergency departments.

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A bacteraemia risk prediction model: development and validation in an emergency medicine population

et al. 2021

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Diagnóstico microbiológico de la bacteriemia y la fungemia: hemocultivos y métodos moleculares

Cited by 25 publications

References 20 publications

Predictive factors of bacteraemia in the patients seen in emergency departments due to infections

Predictive factors of bacteraemia in the patients seen in emergency departments due to infections

Usefulness of the 5MPB-Toledo model to predict bacteremia in patients with community-acquired pneumonia in the Emergency Department

A bacteraemia risk prediction model: development and validation in an emergency medicine population

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