Time to Blood Culture Positivity as a Predictor of Clinical Outcome of
            <i>Staphylococcus aureus</i>
            Bloodstream Infection

Marra, Alexandre R.; Edmond, Michael B.; Forbes, Betty A.; Wenzel, Richard P.; Bearman, Gonzalo

doi:10.1128/jcm.44.4.1342-1346.2006

Cited by 118 publications

(112 citation statements)

References 31 publications

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“…Further, studies showed that a TTP ≤ 14 h was correlated to attributable mortality in bacteremia varying from 11.9% to 18% [3,11,12]. In our study, attributable mortality (27.5%) was higher than those reported in the literature but there was no significant association between TTP and attributable mortality.…”

Section: Time To Positivity: Univariate Analysis and Predictive Valuecontrasting

confidence: 56%

“…First, our elderly population presented an important rate of comorbidities (Charlson score ≥ 5 in 74% patients) that could have influenced mortality in SAB. However, we did not find a relation between attributable mortality and comorbidities as described in the literature [11,13,16]. The second hypothesis is the higher median age (72 years) in our cohort and the even higher age (82 years) among the deceased patients.…”

Section: Time To Positivity: Univariate Analysis and Predictive Valuecontrasting

confidence: 36%

“…The second hypothesis is the higher median age (72 years) in our cohort and the even higher age (82 years) among the deceased patients. In other studies, the population considered was heterogeneous including pediatric patients with a median age inferior to 62 years [3,11,12]. In fact, the only independent factor in our population that influenced the attributable mortality was age.…”

Section: Time To Positivity: Univariate Analysis and Predictive Valuementioning

confidence: 99%

“…The time of the SAB episode was the time of inoculation of the first positive blood culture [14]. Time to positivity of the blood culture was defined as the time between the start of incubation and the time that the automated alert signal indicating growth in the culture bottle sounded [11,12]. In case of multiple positive blood cultures inoculated within maximum two hours, the shortest TTP was taken into account [1,3] SAB was considered as community-acquired if it occurred within 48 h after admission and as nosocomial thereafter [14].…”

Section: Definitionsmentioning

confidence: 99%

“…Only a few studies have described the relationship between TTP and clinical outcome in S. aureus Bacteremia (SAB) [3,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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The Association between Time to Positivity and Staphylococcus Aureus Bacteremia in a Geriatric Population

Maillart¹

2012

J Med Microb Diagn

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Background: Time to Positivity (TTP) of blood cultures is defined as the time elapsed between the start of incubation and the automated alert signal indicating growth in the culture bottle.This study evaluates the TTP of blood cultures in patients with Staphylococcus aureus Bacteremia (SAB) and assesses the relationship between TTP and mortality, Methods:We performed a retrospective study involving adults who had SAB between May 2007 and May 2010 in a tertiary hospital. TTP was defined as the time between onset of incubation and growth detection using an automated blood culture system. Results:A total of 167 SAB were evaluated. Patient's median age was 72 years (range, 18-95 years). The median TTP was 13.6 h (range, 3.6-95.2 h). Attributable mortality rate (27.5%) was not related to the TTP (P=0.558) nor to the comorbidities. Age >60 years was the only independent predictor of attributable mortality (P<0.001). Univariate analysis revealed a significantly shorter TTP in persistent bacteremia, endovascular source of infection, catheter-related infection and in community-acquired SAB. A TTP >11.3 h had a negative predictive value of 96.4% for endocarditis. TTP was not related to methicillin susceptibility nor resistance of Staphylococcus aureus (P=0.934). Conclusion:In our elderly population, shorter TTP was significantly associated with a central source of infection and a persistent SAB. In addition for the first time, community-acquired SAB was associated with a shorter TTP. TTP may contribute to a better management of SAB by facilitating clinical decisions, especially in endocarditis.

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Section: Time To Positivity: Univariate Analysis and Predictive Valuecontrasting

confidence: 56%

Section: Time To Positivity: Univariate Analysis and Predictive Valuecontrasting

confidence: 36%

Section: Time To Positivity: Univariate Analysis and Predictive Valuementioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

“…Only a few studies have described the relationship between TTP and clinical outcome in S. aureus Bacteremia (SAB) [3,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Association between Time to Positivity and Staphylococcus Aureus Bacteremia in a Geriatric Population

Maillart¹

2012

J Med Microb Diagn

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Predominance of Enterobacteriaceae Isolates in Early Positive Anaerobic Blood Culture Bottles in BacT/Alert System

Chiueh

Lee

Tang

et al. 2013

Clinical Laboratory Analysis

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We collected and analyzed the time to detection (TTD) of blood cultures in the BacT/Alert automated system from 2002 to 2007. Among the 10,893 monomicrobial isolates from a total of 133,735 blood culture sets, the recoveries of aerobic bottles were compared with those of anaerobic bottles in this study. Significantly more Gram-positive cocci (except Staphylococcus aureus and enterococci), glucose nonfermentative Gram-negative bacteria, and yeast were recovered from aerobic bottles than from anaerobic bottles. The average TTD was 19.0 hr and 20.1 hr for the aerobic and anaerobic bottles, respectively, and 96.8% of the microorganisms were detected within the first 72 hr. Of the 5,489 microorganisms recovered from both of the blood culture bottle pair, microbial growth was significantly more often detected first in the anaerobic bottles than the aerobic bottles for Enterobacteriaceae except Serratia marcescens, while S. aureus, coagulase-negative staphylococci and Pseudomonas aeruginosa were more often detected first in the aerobic bottles. According to these data, we conclude that the earlier positivity of anaerobic bottles is a useful marker for rapid presumptive identification of Enterobacteriaceae infection.

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Quantitative Fluorescence In Situ Hybridization (FISH) of Magnetically Confined Bacteria Enables Early Detection of Human Bacteremia

et al. 2022

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still blood culture, this method is incapable of providing immediate results to clinicians [1] and often leads to false-negative outcomes. [2] The rapid detection and identification of bacteria in blood is vitally important because the delayed administration of antibiotics results in increased mortality [3,4] and prompt treatment of infection is frequently required for patients, particularly in emergency departments and intensive care units of hospitals. In addition, given that pathogen load is frequently proportional to patient mortality, [5] it is critical to gain quantitative information regarding the bacteria present in blood, which is still achieved largely by blood culture. While time-to-positivity (TTP) of blood cultures has been considered to be a prognostic tool for a limited range of bacterial species, such as Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Streptococcus pneumoniae (S. pneumoniae), [6][7][8][9][10] it has not been applied more widely because correlations between TTP data for certain bacterial species and the mortality of patients was obscure in several clinical studies. [11] Despite these significant drawbacks, blood culture is still the clinical laboratory method most widely used to identify pathogenic bacteria in the blood due to the lack of appropriate, alternative approaches.Mass spectrometry (MS), [12,13] polymerase chain reaction (PCR) [14,15] and loop-mediated isothermal amplification [16] methods have all been incorporated into diagnostic procedures used for the identification of pathogenic bacteria in blood. However, they are often valid only after significant growth, in vitro, of the bacteria present in biological samples. This is often time-consuming and may not be possible, at all, for certain bacterial species due to their insufficient growth rates in standard culture conditions. Although some commercially available MS-and PCR-based diagnostic systems work directly on whole blood, eliminating the most time-consuming step of bacterial culture, [17,18] their clinical impact is still contentious due to inconsistent performance in the presence of inhibitors (e.g., human DNA, iron and heparin) and complex background signals in blood. [19] Fluorescence in situ hybridization (FISH) has permitted the unique capability in a cytogenetic analysis by using fluorescentThe current diagnosis of bacteremia mainly relies on blood culture, which is inadequate for the rapid and quantitative determination of most bacteria in blood. Here, a quantitative, multiplex, microfluidic fluorescence in situ hybridization method (μFISH) is developed, which enables early and rapid (3-h) diagnosis of bacteremia without the need for prior blood culture. This novel technology employs mannose-binding lectin-coated magnetic nanoparticles, which effectively opsonize a broad range of pathogens, magnetically sequestering them in a microfluidic device. Therein, μFISH probes, based on unique 16S rRNA sequences, enable the identification and quantification of sequestered pathogens both in saline a...

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Time to Blood Culture Positivity as a Predictor of Clinical Outcome of Staphylococcus aureus Bloodstream Infection

Cited by 118 publications

References 31 publications

The Association between Time to Positivity and Staphylococcus Aureus Bacteremia in a Geriatric Population

The Association between Time to Positivity and Staphylococcus Aureus Bacteremia in a Geriatric Population

Predominance of Enterobacteriaceae Isolates in Early Positive Anaerobic Blood Culture Bottles in BacT/Alert System

Quantitative Fluorescence In Situ Hybridization (FISH) of Magnetically Confined Bacteria Enables Early Detection of Human Bacteremia

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