Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges

S E Beekmann; D J Diekema; K C Chapin; G V Doern

doi:10.1128/JCM.41.7.3119-3125.2003

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Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges

Journal article

Open access

Peer reviewed

Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges

S E Beekmann, D J Diekema, K C Chapin and G V Doern

Journal of clinical microbiology, Vol.41(7), pp.3119-3125

07/2003

DOI: 10.1128/JCM.41.7.3119-3125.2003

PMCID: PMC165359

PMID: 12843051

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Abstract

Current automated continuous-monitoring blood culture systems afford more rapid detection of bacteremia and fungemia than is possible with non-instrument-based manual methods. Use of these systems has not been studied objectively with respect to impact on patient outcomes, including hospital charges and length of hospitalization. We conducted a prospective, two-center study in which the time from the obtainment of the initial positive blood culture until the Gram stain was called was evaluated for 917 cases of bloodstream infection. Factors showing univariate associations with a shorter time to notification included higher body temperature and respiratory rate and higher percentage of immature neutrophils. Multiple linear regression models determined that the primary predictors of both increased microbiology laboratory and total hospital charges for patients with bloodstream infection were nonmicrobiologic and included length of stay and host factors such as the admitting service and underlying illness score. Significant microbiologic predictors of increased charges included the number of blood cultures obtained, nosocomial acquisition, and polymicrobial bloodstream infections. Accelerated failure time regression analysis demonstrated that microbiologic factors, including time until notification, organism group, and nosocomial acquisition, were independently associated with length of hospitalization after bacteremia, as were the factors of admitting service, gender, and age. Our data suggest that an increased time to notification of bloodstream infection is independently associated with increased length of stay. We conclude that the time to notification is an obvious target for efforts to shorten length of stay. The newest generation of automated continuous-monitoring blood culture systems, which shorten the time required to obtain a positive result, should impact length of hospitalization.

Hospital Charges

Length of Stay

Prospective Studies

Fungi - classification

Humans

Middle Aged

Risk Factors

Fungi - isolation & purification

Male

Bacteremia - diagnosis

Blood - microbiology

Fungemia - microbiology

Fungemia - diagnosis

Bacteremia - microbiology

Regression Analysis

Bacteria - isolation & purification

Time Factors

Culture Media

Adolescent

Aged, 80 and over

Bacteria - classification

Adult

Female

Aged

Details

Title: Subtitle: Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges
Creators: S E Beekmann - Division of Medical Microbiology, Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA. susan-beekmann@uiowa.edu
D J Diekema
K C Chapin
G V Doern
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.41(7), pp.3119-3125
DOI: 10.1128/JCM.41.7.3119-3125.2003
PMID: 12843051
PMCID: PMC165359
NLM abbreviation: J Clin Microbiol
ISSN: 0095-1137
eISSN: 1098-660X
Publisher: United States
Language: English
Date published: 07/2003
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986362002771

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