Do peripheral blood cultures taken in the emergency department influence clinical management?

Abstract

Blood cultures taken in our emergency department rarely yield bacterial growth and over 2 years, only four seemed to directly influence patient management. Better guidelines are required for targeted use of blood cultures in the emergency department.

The Outcome of Blood Cultures in Febrile Children Presenting at theEmergency Department

“…Therefore, the degree of fever was a clinical feature that was associated with bacteremia. Blood culture investigation in adult ED has been questioned, in particularly in immune-competent patients with a common infection or an infection that can be diagnosed by other means, with the conclusion that the BC was of very limited usefulness [33][34][35]. In most of the patients that later was confirmed with a positive BC, empiric antibiotic treatment was started more frequently than in patients with a negative BC (P=0.015), illustrating that other clinical factors, e.g.…”

Impact of bacteremia prediction rule in CAP: Before and after study

“…However, in patients with community acquired pneumonia (CAP), it has been known that the rate of true positive blood cultures is b 10% [2,3]. In emergency departments (ED), the true positive results from blood cultures rarely affected patient management [4,5]. Additionally, ED overcrowding may increase the risk of blood culture contamination [6,7].…”

Biomarcadores y sospecha de infección en los servicios de urgencias

“…Aunque en la mayoría de casos se trata de infecciones de vías urinarias ya diagnosticadas, un 19% corresponde a bacteriemias primarias no identificadas en las cuales cabe replantear el diagnó stico y el tratamiento [9][10][11][12][13][14][15] . En este sentido, diferentes autores han establecido amplias controversias respecto a la indicació n de practicar hemocultivos en los pacientes de los SUH en los que no existe previsió n de ingreso, que todavía no han sido esclarecidas [16][17][18][19][20][21] . Parece evidente que cabe racionalizar la indicació n de practicar hemocultivos en los SUH estableciendo criterios má s objetivos, aunque los esfuerzos por establecer modelos predictivos de bacteriemia mediante las variables clínicas convencionales no han resultado concluyentes [22][23][24] .…”