Clinical factors associated with bloodstream infection at the emergency department

BMC Emergency Medicine

Sumana Sumritrin¹  Pariwat Phungoen²  Nunchalit Lerdprawat²  Kamonwon Ienghong²  Korakot Apiratwarakul²  Kittisak Sawanyawisuth³  Verajit Chotmongkol³ 

[1] Accidental and Emergency Unit, Division of Nursing, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, 123/2000 Mitraparp Rd, Muang, 40002, Khon Kaen, Thailand;Department of Medicine, Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;

关键词: Bloodstream infection;    Bacteremia;    Blood cultures;    Rapid diagnosis;    Emergency department;   

DOI  :  10.1186/s12873-021-00426-2

来源: Springer

【 摘 要 】

BackgroundBloodstream infection (BSI) is a common urgent condition at the emergency department (ED). However, current guidelines for diagnosis do not specify the juncture at which blood cultures should be taken. The decision whether or not to obtain hemoculture is based solely upon clinical judgment and potential outcomes of inappropriately ordered cultures. This study aimed to find clinical factors present on ED arrival that are predictive of bloodstream infection.MethodsThis study was conducted retrospectively at the ED of a single tertiary care hospital in Thailand. We included adult patients with suspected infection based on blood culture who were treated with intravenous antibiotics during their ED visit. Independent positive predictors for positive blood culture were calculated by logistic regression analysis.ResultsA total of 169,578 patients visited the ED during the study period, 12,556 (7.40%) of whom were suspected of infection. Of those, 8177 met the study criteria and were categorized according to blood culture results (741 positive; 9.06%). Six clinical factors, including age over 55 years, moderate to severe CKD, solid organ tumor, liver disease, history of chills, and body temperature of over 38.3 °C, were associated with positive blood culture.ConclusionsClinical factors at ED arrival can be used as predictors of bloodstream infection.

【 授权许可】

CC BY