Time to blood culture positivity as a predictor of clinical outcome of Staphylococcus aureus bloodstream infection

Time to blood culture positivity as a predictor of clinical outcome of Staphylococcus aureus bloodstream infection

Autor Marra, Alexandre R. Autor UNIFESP Google Scholar
Edmond, Michael B. Google Scholar
Forbes, Betty A. Google Scholar
Wenzel, Richard P. Google Scholar
Bearman, Gonzalo ML Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Virginia Commonwealth Univ
Resumo Few studies have assessed the time to blood culture positivity as a predictor of clinical outcome in bloodstream infections (BSIs). the purpose of this study was to evaluate the time to positivity (TTP) of blood cultures in patients with Staphylococcus aureus BSIs and to assess its impact on clinical outcome. We performed a historical cohort study with 91 adult patients with S. aureus BSIs. TTP 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. Patients with BSIs and TTPs of culture of <= 12 h (n = 44) and > 12 h (n = 47) were compared. Septic shock occurred in 13.6% of patients with TTPs of <= 12 h and in 8.5% of patients with TIP of > 12 h (P = 0.51). A central venous catheter source was more common with a BSI TTP of :512 h (P = 0.010). Univariate analysis revealed that a Charlson score of >= 3, the failure of at least one organ (respiratory, cardiovascular, renal, hematologic, or hepatic), infection with methicillin-resistant S. aureus, and TTPs of <= 12 h were associated with death. Age, gender, an APACHE II score of >= 20 at BSI onset, inadequate empirical antibiotic therapy, hospital-acquired bacteremia, and endocarditis were not associated with mortality. Multivariate analysis revealed that independent predictors of hospital mortality were a Charlson score of >= 3 (odds ratio [OR], 14.4; 95% confidence interval [CI], 2.24 to 92.55), infection with methicillin-resistant S. aureus (OR, 9.3; 95% CI, 1.45 to 59.23), and TTPs of <= 12 h (OR, 6.9; 95% Cl, 1.07 to 44.66). in this historical cohort study of BSIs due to S. aureus, a TTP of :512 h was a predictor of the clinical outcome.
Idioma Inglês
Data de publicação 2006-04-01
Publicado em Journal of Clinical Microbiology. Washington: Amer Soc Microbiology, v. 44, n. 4, p. 1342-1346, 2006.
ISSN 0095-1137 (Sherpa/Romeo, fator de impacto)
Publicador Amer Soc Microbiology
Extensão 1342-1346
Fonte http://dx.doi.org/10.1128/JCM.44.4.1342-1346.2006
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000236810500021
Endereço permanente http://repositorio.unifesp.br/handle/11600/28805

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