Article Text

Download PDFPDF

Bacteraemia predictive factors among general medical inpatients: a retrospective cross-sectional survey in a Japanese university hospital
  1. Sayato Fukui1,
  2. Yuki Uehara1,2,
  3. Kazutoshi Fujibayashi1,
  4. Osamu Takahashi3,
  5. Teruhiko Hisaoka1,
  6. Toshio Naito1,2
  1. 1Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
  2. 2Department of Infection Control Science, Faculty of Medicine, Juntendo University, Tokyo, Japan
  3. 3Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
  1. Correspondence to Dr Sayato Fukui; sfukui{at}juntendo.ac.jp

Abstract

Objectives The precise criteria for obtaining blood cultures have not been established; they depend on the physician's judgement. We examined clinical parameters to determine predictive factors of bacteraemia and the need for blood cultures among general medical inpatients.

Design A retrospective cross-sectional survey.

Setting A Japanese university hospital.

Participants All general inpatients who had blood cultures taken from 1 January 2011 to 31 December 2012.

Main Measures Clinical information at or just before blood culture sampling was extracted from medical charts. Factors potentially predictive of bacteraemia were analysed using Fisher's exact test, followed by multivariable logistic regression model analysis.

Main Results A total of 200 patients (male: female=119:81, 64.3±19.1 years old) comprised this study; 57 (28.5%) had positive blood culture results. Multivariable logistic regression analysis revealed that age >60 years (OR=2.75, 95% CI 1.23 to 6.48, p=0.015), female sex (OR=2.21, 95% CI 1.07 to 4.67, p=0.038), pulse rate >90 bpm (OR=5.18, 95% CI 2.25 to 12.48, p<0.001) and neutrophil percentage >80% (OR=3.61, 95% CI 1.71 to 8.00, p=0.001) were independent risk factors for positive blood culture results. The area under the receiver operating characteristic curve analysis of this model was 0.796.

Conclusions Our results emphasise the importance of taking blood cultures if the pulse rate is >90 bpm, in elderly patients and in women, and for ordering a differential white cell count.

  • GENERAL MEDICINE (see Internal Medicine)
  • INFECTIOUS DISEASES

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

View Full Text

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.