Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: a prospective clinical cohort study

Scheer, Christian; Fuchs, Christian; Gründling, Matthias; Vollmer, Marcus; J, Bast; Bohnert, Jürgen A.; Zimmermann, Katrin; Hahnenkamp, Klaus; Rehberg, Sebastian; Kuhn, Sven–Olaf

doi:10.1016/j.cmi.2018.05.016

Cited by 159 publications

(95 citation statements)

References 26 publications

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“…17 Therefore, for effective management of endogenous endophthalmitis, blood samples should be collected before starting antibiotic treatment. 18 Liver abscess-associated endophthalmitis can signi cantly impact the visual acuity of patients, and has a poor prognosis. A study conducted in Southern California investigating endophthalmitis caused by Klebsiella pneumoniae showed that approximately half of the patients required enucleation.…”

Section: Discussionmentioning

confidence: 99%

Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

Wang

2020

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Backgrounds: Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess.Methods: Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgery.Results: Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction.Conclusion: Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.

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Section: Discussionmentioning

confidence: 99%

Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

Wang

2020

Preprint

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“…The reasons for the continuous increment of culture-negativity could be multifactorial. First, the patients could have been prescribed empirical antibiotics at local clinics before sepsis developed [14]. Second, the proportion of sepsis cases caused by atypical pathogens, including viral and fungal infections, might be increasing [15,16].…”

Section: Discussionmentioning

confidence: 99%

Culture-negative and culture-positive septic shock: characteristics and clinical outcomes

Kim

2020

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Background We evaluated the characteristics and outcomes of culture-negative septic shock versus culture-positive septic shock.Methods We performed a retrospective observational study of data from a prospective registry from 2014 to 2018. A total of 2,499 adult patients with septic shock were enrolled. The primary outcome was 90-day mortality, and the secondary outcomes were the length of hospital stay, a requirement for mechanical ventilation or renal replacement therapy, and in-hospital mortality.Results Of 1,718 patients with septic shock, 1,012 (58.9%) patients were culture-positive (blood 803, urine 302, sputum 102, others 204) and the median pathogen detection time was 9.5 hours (aerobic 10.2 hours and anaerobic 9.0 hours). The most common site of infection among the culture-positive was the hepatobiliary tract (39.5%), while for the culture-negative was the lower respiratory tract (38.2%). The culture-negative group had a lower mean body temperature (37.3 vs 37.7 ℃), lactate (2.5 vs. 3.2 mmol/L), C-reactive protein (11.1 vs 11.9 mg/dL), and sequential organ failure assessment score (7.0 vs. 8.0) than that of the culture-positive group. However, 90-day mortality between the groups was not significantly different (32.7 vs 32.2%, p = 0.83), and the other clinical outcomes also did not differ significantly. Moreover, a shorter culture detection time was correlated with a higher sequential organ failure assessment score but not with mortality.Conclusion Patients with septic shock are frequently culture-negative, especially in cases where the infection focus is in the lower respiratory tract. Although culture-negative was associated with degree of organ dysfunction, it was not an independent predictor of death.

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“…Es ist enorm wichtig, die Blutkulturabnahme vor Beginn einer antiinfektiven Therapie durchzuführen, da ein Erregernachweis unter antiinfektiver Therapie erheblich seltener gelingt [12]. Durch die Blutkulturabnahmen darf sich der Beginn der antiinfektiven Therapie allerdings nicht wesentlich verzögern.…”

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Notfall Sepsis: Erkennen, Diagnose, Therapie

Gründling¹,

Gibb²,

Kuhn³

2019

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Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: a prospective clinical cohort study

Abstract: Obtaining blood cultures during antibiotic therapy is associated with a significant loss of pathogen detection. This strongly emphasizes the current recommendation to obtain blood cultures before antibiotic administration in patients with sepsis.

Cited by 159 publications

References 26 publications

Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

Culture-negative and culture-positive septic shock: characteristics and clinical outcomes

Notfall Sepsis: Erkennen, Diagnose, Therapie

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