Limited Clinical Utility of Follow-up Blood Cultures in Patients With Streptococcal Bacteremia: An Opportunity for Blood Culture Stewardship

Siegrist, Emily A; Wungwattana, Minkey; Azis, Leyla; Stogsdill, Patricia; Craig, Wendy Y.; Rokas, Kristina

doi:10.1093/ofid/ofaa541

Cited by 4 publications

(3 citation statements)

References 19 publications

(4 reference statements)

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“…Evidence for the rest of Gram-positives is scarce. FUBCs have limited utility in streptococcal bacteremia, and their collection should be limited in patients at low risk for deep infections, persistent bacteremia or endovascular infection [ 151 ].…”

Section: In Which Cases Are Follow-up Blood Cultures Indicated After ...mentioning

confidence: 99%

Unresolved issues in the epidemiology and diagnosis of bacteremia: an opinion paper

Alonso-Menchén¹,

Muñóz²,

Sánchez‐Carrillo³

et al. 2022

Rev Esp Quimioter

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Bacteremia is an important cause of morbidity and mortality worldwide and, despite the diagnostic and therapeutic advances of the last decades, the evidence supporting many diagnostic aspects of bacteremia is scarce. Information on the epidemiological evolution of this entity is limited and many methodological aspects of blood culture collection and analysis are under discussion. Furthermore, the recommendations of the main scientific societies on many of these aspects are variable and, in many cases, have not been updated recently. In this scenario, we have arranged a series of questions on different aspects of bacteremia and reviewed the literature trying to find proper answers for them. We offer our opinion on the topics where the evidence was weak. The topics covered include epidemiological aspects of bacteremia, indications for blood culture extraction, methods for obtaining and incubating samples, or ways of transmitting results from the microbiology laboratory. We do not intend to summarize the current clinical practice guidelines, nor will we deal with the therapeutic management of this entity. The aim of this paper is to review the current perspective on the diagnosis of bacteremia with a critical approach, to point out the gaps in the literature, to offer the opinion of a team dedicated to infectious diseases and clinical microbiology, and to identify some areas of knowledge on which future studies should focus.

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Section: In Which Cases Are Follow-up Blood Cultures Indicated After ...mentioning

confidence: 99%

Unresolved issues in the epidemiology and diagnosis of bacteremia: an opinion paper

Alonso-Menchén¹,

Muñóz²,

Sánchez‐Carrillo³

et al. 2022

Rev Esp Quimioter

View full text Add to dashboard Cite

show abstract

“…2,3 Streptococcal infections have an overall low prevalence of positive follow-up blood cultures, but infections leading to positive follow-up blood cultures have been shown to require longer durations of antibiotic treatment. 4 Unfortunately, prolonged VAN courses confer an increased risk of nephrotoxicity. 5 Pharmacokinetic/pharmacodynamic monitoring of VAN using the area under the curve (AUC) to minimum inhibitory concentration (MIC) ratio is now the preferred monitoring approach to prevent nephrotoxicity and ensure clinical efficacy in serious methicillin-resistant Staphylococcus aureus (MRSA) infections.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between Vancomycin AUC and Clinical Failure in Patients with Streptococcal Bacteremia

et al. 2022

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Background: Monitoring of vancomycin using the area under the curve (AUC) to minimum inhibitory concentration (MIC) ratio is now preferred for serious methicillin-resistant Staphylococcus aureus infections. Vancomycin AUC/MIC monitoring is being investigated but is not yet well elucidated with other bacterial pathogens. Methods: A retrospective cross-sectional study was conducted assessing patients with streptococcal bacteremia treated with vancomycin definitive therapy. AUC was calculated using a Bayesian approach, and classification and regression tree analysis was used to identify a vancomycin AUC threshold predictive of clinical failure. Results: Eleven patients had a vancomycin AUC < 329 of which 8 (73%) experienced clinical failure, while 35 patients had a vancomycin AUC ≥ 329 of which 12 (34%) experienced clinical failure ( P = .04). Hospital length of stay was longer in the AUC ≥ 329 group (15 vs 8 days, P = .05), whereas time to bacteremia clearance (29 [22-45] vs 25 [20-29] hours, P = .15) and toxicity incidence (13% vs 4%, P = 1) were similar between groups. Conclusions: This study identified a VAN AUC threshold of <329 to be predictive of clinical failure in patients with streptococcal bacteremia which should be interpreted as hypothesis-generating. Studies evaluating VAN AUC-based monitoring for streptococcal bloodstream infections along with other infection types are needed before implementation into clinical practice can be recommended.

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Bacteraemia with gram-positive bacteria—when and how do I need to look for endocarditis?

Rasmussen,

Gilje,

Fagman

et al. 2024

Clinical Microbiology and Infection

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Limited Clinical Utility of Follow-up Blood Cultures in Patients With Streptococcal Bacteremia: An Opportunity for Blood Culture Stewardship

Cited by 4 publications

References 19 publications

Unresolved issues in the epidemiology and diagnosis of bacteremia: an opinion paper

Unresolved issues in the epidemiology and diagnosis of bacteremia: an opinion paper

Association Between Vancomycin AUC and Clinical Failure in Patients with Streptococcal Bacteremia

Bacteraemia with gram-positive bacteria—when and how do I need to look for endocarditis?

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