Prognostic roles of time to positivity of blood cultures in patients with Escherichia coli bacteremia. (2020)

• Record Type: Journal Article
• Authors: Chen, Yufang; Huang, Xun; Wu, Anhua; Lin, Xuan; Zhou, Pengcheng; Liu, Yao; Wu, Yayun; Fu, Chenchao; Dou, Qingya; Jiang, Huaye
• Is Part Of: Epidemiology and infection. Volume 148(2020)
• Publication Date: 2020
• Subjects: Blood culture, -- E. coli bacteremia, -- mortality, -- prognostic roles, -- time to positivity; Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268820000941
• Languages: English
• ISSNs: 0950-2688

Abstract

Abstract: The time to positivity (TTP) of blood cultures has been considered a predictor of clinical outcomes for bacteremia. This retrospective study aimed to determine the clinical value of TTP for the prognostic assessment of patients with Escherichia coli bacteremia. A total of 167 adult patients with E.coli bacteremia identified over a 22-month period in a 3500-bed university teaching hospital in China were studied. The standard cut-off TTP was 11 h in the patient cohort. The septic shock occurred in 27.9% of patients with early TTP (⩽11 h) and in 7.1% of those with a prolonged TTP (>11 h) ( P = 0.003). The mortality rate was significantly higher for patients in the early than in the late group (17.7% vs. 4.0%, P < 0.001). Multivariate analysis showed that an early TTP (OR 4.50, 95% CI 1.70–11.93), intensive care unit admission (OR 8.39, 95% CI 2.01–35.14) and neutropenia (OR 4.20, 95% CI 1.55–11.40) were independently associated with septic shock. Likewise, the independent risk factors for mortality of patients were an early TTP (OR 3.80, 95% CI 1.04–12.90), intensive care unit admission (OR 6.45; 95% CI 1.14–36.53), a Pittsburgh bacteremia score ⩾2 (OR 4.34, 95% CI 1.22–15.47) and a Charlson Comorbidity Index ⩾3 (OR 11.29, 95% CI 2.81–45.39). Overall, a TTP for blood cultures within 11 h appears to be associated with worse outcomes for patients with E.coli bacteremia.