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A Multicentre Study about Pattern and Organisms Isolated in Follow-up Blood Cultures

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Background: This study analysed patterns of requests for repeated blood cultures and the microorganisms isolated in follow-up cultures. Methods: The frequencies and intervals of repeated blood cultures performed during January and February of 2010 at seven university-affiliated hospitals in Korea were evaluated. Results of microbiological cultures at follow-up were analysed with respect to pathogen replication, immune clearance, appearance of new pathogens, and skin contaminants. Results: Among 3,072 patients who received repeated blood cultures, the average number of requests was 3.2. Of the 5,241 follow-up blood culture events recorded, durations of 1, 2, and 3 days between cultures were identified for 23.1%, 21.4%, and 15.0% of events, respectively. Relative to each initial culture, persistent pathogen growth in subsequent culture(s) accounted for 2.3% of events, whereas immune clearance was confirmed in 8.5% of events. Previously undetected pathogens were isolated in 5.2% of the follow-up cultures, the majority of which grew after an interval of six days. Skin contaminants were detected in 7.6% of the repeated cultures, and 76.1% of the follow-ups displayed no growth of microorganisms. Conclusion: The most common numbers of repeat culture requests were two and three, and these were typically performed within three days of the initial culture. Among the follow-up cultures, new pathogens were identified in 5.2%, and the majority of this group likely presented for follow-up during a new disease episode.

Abstract

Background: This study analysed patterns of requests for repeated blood cultures and the microorganisms isolated in follow-up cultures. Methods: The frequencies and intervals of repeated blood cultures performed during January and February of 2010 at seven university-affiliated hospitals in Korea were evaluated. Results of microbiological cultures at follow-up were analysed with respect to pathogen replication, immune clearance, appearance of new pathogens, and skin contaminants. Results: Among 3,072 patients who received repeated blood cultures, the average number of requests was 3.2. Of the 5,241 follow-up blood culture events recorded, durations of 1, 2, and 3 days between cultures were identified for 23.1%, 21.4%, and 15.0% of events, respectively. Relative to each initial culture, persistent pathogen growth in subsequent culture(s) accounted for 2.3% of events, whereas immune clearance was confirmed in 8.5% of events. Previously undetected pathogens were isolated in 5.2% of the follow-up cultures, the majority of which grew after an interval of six days. Skin contaminants were detected in 7.6% of the repeated cultures, and 76.1% of the follow-ups displayed no growth of microorganisms. Conclusion: The most common numbers of repeat culture requests were two and three, and these were typically performed within three days of the initial culture. Among the follow-up cultures, new pathogens were identified in 5.2%, and the majority of this group likely presented for follow-up during a new disease episode.

참고문헌 (6)

  1. Clinical and Laboratory Standards Institute, "Principles and Procedures for Blood Cultures; Approved Guideline", Clinical and Laboratory Standards Institute, ~, pp.Document M47-A (2007)
  2. Fowler VG Jr, "Clinical identifiers of complicated Staphylococcus aureus bacteremia", Arch Intern Med, 163, pp.2066~2072 (2003)
  3. Mylotte JM, "Blood cultures: clinical aspects and controversies", Eur J Clin Microbiol Infect Dis, 19, pp.157~163 (2000)
  4. Grace CJ, "Usefulness of blood culture for hospitalized patients who are receiving antibiotic therapy", Clin Infect Dis, 32, pp.1651~1655 (2001)
  5. Sarkar S, "Role of multiple site blood cultures to document the clearance of bacteremia in neonates", J Perinatol, 27, pp.101~102 (2007)
  6. Hall KK, "Updated review of blood culture contamination", Clin Microbiol Rev, 19, pp.788~802 (2006)

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