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

Alexandre R Marra; Michael B Edmond; Betty A Forbes; Richard P Wenzel; Gonzalo M L Bearman

doi:10.1128/JCM.44.4.1342-1346.2006

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

Journal article

Open access

Peer reviewed

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

Alexandre R Marra, Michael B Edmond, Betty A Forbes, Richard P Wenzel and Gonzalo M L Bearman

Journal of clinical microbiology, Vol.44(4), pp.1342-1346

04/2006

DOI: 10.1128/JCM.44.4.1342-1346.2006

PMCID: PMC1448655

PMID: 16597860

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Abstract

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 TTP of >12 h (P = 0.51). A central venous catheter source was more common with a BSI TTP of </=12 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% CI, 1.07 to 44.66). In this historical cohort study of BSIs due to S. aureus, a TTP of </=12 h was a predictor of the clinical outcome.

Prognosis

Staphylococcus aureus - isolation & purification

Humans

Middle Aged

Bacteremia - mortality

Male

Sepsis - complications

Bacteremia - diagnosis

Sepsis - mortality

Staphylococcal Infections - diagnosis

Aged, 80 and over

Adult

Female

Aged

Retrospective Studies

Cell Culture Techniques

Sepsis - microbiology

Staphylococcal Infections - blood

Details

Title: Subtitle: Time to blood culture positivity as a predictor of clinical outcome of Staphylococcus aureus bloodstream infection
Creators: Alexandre R Marra - A. D. Williams Clinic, 1201 East Marshall Street, 6th Floor, Room 6-602, P.O. Box 980019, Richmond, VA 23298, USA. a.marra@uol.com.br
Michael B Edmond
Betty A Forbes
Richard P Wenzel
Gonzalo M L Bearman
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.44(4), pp.1342-1346
Publisher: United States
DOI: 10.1128/JCM.44.4.1342-1346.2006
PMID: 16597860
PMCID: PMC1448655
ISSN: 0095-1137
eISSN: 1098-660X
Language: English
Date published: 04/2006
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9983905638202771

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