Usefulness of Blood Culture for Hospitalized Patients Who Are Receiving Antibiotic Therapy

Grace, Christopher; Lieberman, J E; Pierce, Kristen J.; Littenberg, Benjamin

doi:10.1086/320527

Cited by 97 publications

(76 citation statements)

References 8 publications

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“…Antibiotic treatment before sampling reduces the effectiveness of blood cultures. 6,7 The advantage of a DNA-based detection system is that the microorganism causing sepsis does not have to be live at the time of sampling. In our research, detection of pathogens by SeptiFast was not affected by start of antibiotic treatment before sampling.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the sensitivity of blood culture is greatly reduced when samples are obtained after antimicrobial therapy has started. 6,7 Molecular methods allow rapid detection of the microorganisms involved in severe infections, leading to more efficient and more accurately targeted early therapeutic interventions, which could mean major clinical benefits for patients. 8 The LightCycler SeptiFast Test (SeptiFast, Roche Diagnostics) is a multipathogen probe-based real-time polymerase chain reaction (PCR) system targeting DNA sequences of bacteria and fungi in blood samples, and it is considered to be a potentially valuable complementary tool in the management of patients with suspected sepsis.…”

mentioning

confidence: 99%

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Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Suberviola

Márquez-López

Castellanos-Ortega

et al. 2015

American Journal of Critical Care

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Objective To compare the utility of a multiplex polymerase chain reaction system (SeptiFast) and blood cultures for detecting bacteria and fungi in blood samples from patients with severe sepsis or septic shock. Methods In a prospective observational study, whole blood samples for SeptiFast testing and for culture were collected on admission from all patients with severe sepsis or septic shock admitted to the intensive care unit between July 2011 and September 2012. SeptiFast results were compared with blood and other culture results. Results The probability of at least 1 microorganism being isolated at 6 hours was 13-fold higher with the SeptiFast test than with blood cultures (relative risk, 13.5; 95% CI, 5.05-36.06). Unlike culture results, SeptiFast test results were not associated with previous antibiotic consumption. The median time to the first positive blood culture result was 17 hours; SeptiFast results were available in 6 hours. SeptiFast detected genetic material from potentially multiresistant microorganisms in patients whose blood cultures showed no growth at all. Conclusions The SeptiFast test provided quicker microbiological diagnosis and identified significantly more microorganisms than blood cultures did, particularly when samples were collected after antibiotic therapy had started or infections were due to resistant bacteria and yeast.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Suberviola

Márquez-López

Castellanos-Ortega

et al. 2015

American Journal of Critical Care

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“…Blood culture rarely isolates causative organisms after initiation of antibiotic therapy. 15,25 Antibiotics decrease the yield of blood cultures, and routine collection of blood samples may not be helpful in allo-SCT recipients. However, our study revealed a high incidence of 'occult' BSI in these patients.…”

Section: Discussionmentioning

confidence: 99%

Value of surveillance blood culture for early diagnosis of occult bacteremia in patients on corticosteroid therapy following allogeneic hematopoietic stem cell transplantation

Chizuka¹,

Kami²,

Kanda

et al. 2005

Bone Marrow Transplant

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Summary:Bloodstream infection (BSI) is a significant complication following allogeneic hematopoietic stem cell transplantation (allo-SCT). Corticosteroids mask inflammatory responses, delaying the initiation of antibiotics. We reviewed medical records of 69 allo-SCT patients who had been on 40.5 mg/kg prednisolone to investigate the efficacy of weekly surveillance blood cultures. A total of 36 patients (52%) had positive cultures, 25 definitive BSI and 11 probable BSI. Pathogens in definitive BSI were Staphylococcus epidermidis (n ¼ 7), S. aureus (n ¼ 4), Entrococcus faecalis (n ¼ 3), Pseudomonas aeruginosa (n ¼ 5), Acenitobacter lwoffii (n ¼ 4), and others (n ¼ 10). The median interval from the initiation of corticosteroids to the first positive cultures was 24 days (range, 1-70). At the first positive cultures, 15 patients with definitive BSI were afebrile. Four of them remained afebrile throughout the period of positive surveillance cultures. Patients with afebrile BSI tended to be older (P ¼ 0.063), and had indwelling central venous catheters less frequently than febrile patients (Po0.0001). Bloodstream pathogens were directly responsible for death in two patients with afebrile BSI. This study demonstrates that cortisosteroid frequently masks inflammatory reactions in allo-SCT recipients given conrticosteroids, and that surveillance blood culture is only diagnostic clue for 'occult' BSI.

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“…The presence of a blood pathogen represents a negative prognostic factor, but the isolation of such pathogen is important for verifying the appropriateness of antibiotic therapy, which in turn is known to reduce morbidity and mortality (Grace, et al, 2001). Also, falsepositive results due to bacterial contaminants may lead to unnecessary antibiotic therapy, longer hospital stays and selection of resistant microorganisms (Bates, et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Bacteriologic Profile and Antimicrobial Resistance of Blood Culture Isolates of Septicemic Patients from Various Intensive Care Units in a Teaching Tertiary Care Institute of Haryana, India

Sangwan¹,

Mane²,

Vohra³

et al. 2016

Int.J.Curr.Microbiol.App.Sci

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Usefulness of Blood Culture for Hospitalized Patients Who Are Receiving Antibiotic Therapy

Cited by 97 publications

References 8 publications

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Value of surveillance blood culture for early diagnosis of occult bacteremia in patients on corticosteroid therapy following allogeneic hematopoietic stem cell transplantation

Bacteriologic Profile and Antimicrobial Resistance of Blood Culture Isolates of Septicemic Patients from Various Intensive Care Units in a Teaching Tertiary Care Institute of Haryana, India

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