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- Title
Rate and predictors of blood culture positivity after antibiotic administration: a prospective single-center study.
- Authors
Zornitzki, Lior; Anuk, Lana; Frydman, Shir; Morag-Koren, Nira; Zahler, David; Freund, Ophir; Biran, Roni; Liron, Yael; Tau, Luba; Tchebiner, Joseph Zvi; Katash, Haitam; Bornstein, Gil
- Abstract
Purpose: Blood culture obtainment prior to antibiotic administration, in patients with suspected infection, is considered the best practice in international guidelines. However, there is little data regarding the effect of a single dose of antibiotics on blood culture sterilization. Methods: We conducted a prospective study, enrolling consecutive patients with suspected infection, hospitalized in an internal medicine ward between December 2019 and January 2023. Included patients had a positive blood culture prior to antibiotic administration and a set of blood cultures taken within 24 h after a single dose of antibiotics. The rate of patients with pathogen isolation after antibiotic administration was assessed. Logistic regression was performed to examine factors associated with blood culture positivity. Results: A total of 155 patients were recruited for the study of which 131 (50.8% female 77.5 ± 13.4 years) met the inclusion criteria. The overall rate of patients with a positive blood culture after a single dose of antibiotics was 42.0% (55/131 patients). Increasing time between antibiotic administration and post-antibiotic culture was an independent predictor for blood culture sterilization (odds ratio 0.89 [95% confidence interval, 0.83–0.97; p = 0.006] for every 60 min). Blood culture volume was an independent predictor for blood culture positivity in a sensitivity analysis which included 82 patients (OR = 1.26 [95% CI 1.03–1.57] for every 1 ml increase; p = 0.024). Conclusion: Blood culture positivity is reduced by antimicrobial therapy but remains high after a single dose of antibiotics. If cultures are not obtained prior to antibiotic administration, they should be obtained as soon as possible afterwards.
- Subjects
ISRAEL; BLOOD; ANTIBIOTICS; RISK assessment; ACADEMIC medical centers; MICROBIAL sensitivity tests; STAPHYLOCOCCAL diseases; BACTEREMIA; LOGISTIC regression analysis; PROPIONIBACTERIUM; HEMOGLOBINS; IMMUNOTHERAPY; TERTIARY care; DESCRIPTIVE statistics; VIRIDANS strepotococci; CHI-squared test; MULTIVARIATE analysis; HOSPITAL mortality; CELL culture; LONGITUDINAL method; ODDS ratio; KLEBSIELLA infections; INTERNAL medicine; BACTERIAL contamination; ESCHERICHIA coli diseases; CONFIDENCE intervals; BACILLACEAE diseases; DATA analysis software; CEPHALOSPORINS; AMINOGLYCOSIDES; COMPARATIVE studies; HOSPITAL wards; PENICILLIN
- Publication
Infection, 2024, Vol 52, Issue 2, p483
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-023-02105-9