Diagnosis of blood culture-negative endocarditis and clinical comparison between blood culture-negative and blood culture-positive cases

Infection ◽  
2015 ◽  
Vol 44 (4) ◽  
pp. 459-466 ◽  
Author(s):  
Cristiane C. Lamas ◽  
Pierre-Edouard Fournier ◽  
Monica Zappa ◽  
Tatiana J. D. Brandão ◽  
Carolina A. Januário-da-Silva ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Comparison ◽  
Culture Positive ◽  
Culture Negative

scholarly journals Predictive and prognostic factors in patients with blood-culture-positive community-acquired pneumococcal pneumonia

2016 ◽  
Vol 48 (3) ◽  
pp. 797-807 ◽  
Author(s):  
Rosanel Amaro ◽  
Adamantia Liapikou ◽  
Catia Cilloniz ◽  
Albert Gabarrus ◽  
Francesc Marco ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Blood Culture ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Pneumonia ◽  
Protective Factor ◽  
Severe Pneumonia ◽  
Increased Risk ◽  
Culture Positive ◽  
Culture Negative

In patients with pneumococcal community-acquired pneumonia (CAP), the risk factors for bacteraemia and its impact on outcomes are not fully elucidated. We aimed to compare characteristics of patients with blood-culture-positiveversusblood-culture-negative pneumococcal CAP, and to characterise bacteraemic serotypes.We describe a prospective, observational study on nonimmunocompromised patients with pneumococcal CAP, from 1996 to 2013. We define severe pneumonia according to American Thoracic Society/Infectious Diseases Society of America guidelines.Of a total of 917 patients with pneumococcal CAP, 362 had blood-culture-positive pneumococcal pneumonia (BCPPP; 39%). High C-reactive protein (CRP) (≥20 mg·dL−1) (odds ratio (OR) 2.36, 95% CI 1.45–3.85), pleural effusion (OR 2.03, 95% CI 1.13–3.65) and multilobar involvement (OR 1.69, 95% CI 1.02–2.79) were independently associated with bacteraemic CAP, while nursing home resident (OR 0.12, 95% CI 0.01–1.00) was found as a protective factor. Despite the clinical differences, BCPPP showed similar outcomes to blood-culture-negative pneumococcal pneumonia (BCNPP). 14% of the serotypes (period 2006–2013) causing bacteraemia are included in pneumococcal conjugate vaccine PVC7, 74% in pneumococcal conjugate vaccine PVC13 and 83% in pneumococcal polysaccharide vaccine PPSV23.Pleural effusion, a high level of CRP and multilobar involvement predicted an increased risk of BCPPP. Although BCPPP patients were more severely ill at admission, mortality was not significantly greater than in BCNPP patients.

Reassessment of Blood Culture-Negative Endocarditis: Its Profile Is Similar to That of Blood Culture-Positive Endocarditis

2012 ◽  
Vol 65 (10) ◽  
pp. 891-900 ◽  
Author(s):  
Carlos Ferrera ◽  
Isidre Vilacosta ◽  
Cristina Fernández ◽  
Javier López ◽  
Carmen Olmos ◽  
...  
Keyword(s):  
Blood Culture ◽  
Culture Positive ◽  
Culture Negative

scholarly journals Comparing mortality between positive and negative blood culture results: an inverse probability of treatment weighting analysis of a multicenter cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aibo Liu ◽  
Chia-Hung Yo ◽  
Lu Nie ◽  
Hua Yu ◽  
Kuihai Wu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Culture ◽  
Early Mortality ◽  
Negative Blood Culture ◽  
Late Mortality ◽  
Inverse Probability ◽  
Propensity Score Model ◽  
Significant Difference ◽  
Culture Positive ◽  
Culture Negative

Abstract Background The association between blood culture status and mortality among sepsis patients remains controversial hence we conducted a tri-center retrospective cohort study to compare the early and late mortality of culture-negative versus culture-positive sepsis using the inverse probability of treatment weighting (IPTW) method. Methods Adult patients with suspected sepsis who completed the blood culture and procalcitonin tests in the emergency department or hospital floor were eligible for inclusion. Early mortality was defined as 30-day mortality, and late mortality was defined as 30- to 90-day mortality. IPTW was calculated from propensity score and was employed to create two equal-sized hypothetical cohorts with similar covariates for outcome comparison. Results A total of 1405 patients met the inclusion criteria, of which 216 (15.4%) yielded positive culture results and 46 (21.3%) died before hospital discharge. The propensity score model showed that diabetes mellitus, urinary tract infection, and hepatobiliary infection were independently associated with positive blood culture results. There was no significant difference in early mortality between patients with positive or negative blood culture results. However, culture-positive patients had increased late mortality as compared with culture-negative patients in the full cohort (IPTW-OR, 1.95, 95%CI: 1.14–3.32) and in patients with severe sepsis or septic shock (IPTW-OR, 1.92, 95%CI: 1.10–3.33). After excluding Staphylococcal bacteremia patients, late mortality difference became nonsignificant (IPTW-OR, 1.78, 95%CI: 0.87–3.62). Conclusions Culture-positive sepsis patients had comparable early mortality but worse late mortality than culture-negative sepsis patients in this cohort. Persistent Staphylococcal bacteremia may have contributed to the increased late mortality.

scholarly journals Neonatal Sepsis-Culture Positive Sepsis Vs Clinical Sepsis

2017 ◽  
Vol 6 (1) ◽  
pp. 1362
Author(s):  
Purbasha Ghosh ◽  
Rabindra Nath Misra ◽  
Retina Paul
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Gold Standard ◽  
Methicillin Resistance ◽  
High Morbidity ◽  
Sepsis Screen ◽  
Culture Positive ◽  
Culture Negative

<p><strong>Background</strong>: The incidence of sepsis is increasing globally, with high morbidity and mortality. Diagnosis of neonatal sepsis is still a clinical and laboratory challenge. Though blood culture is gold standard, it sometimes gives false negative result. So, judgement of clinical condition along with various investigations is important.</p><p><strong>Objectives</strong>: To find out the risk factors associated with neonatal sepsis, to isolate&amp;amp;identify the pathogens from various clinical specimens and to find out antimicrobial susceptibility of the pathogens.</p><p><strong>Material and methods</strong>: Blood culture, sepsis screen, haematological&amp;amp;biochemical markers, cerebrospinal fluid (CSF) study, radiology, MRSA (methicillin resistance Staphylococcus aureus) surveillance were carried out in this study. Some samples were processed in BacT/ALERT-3D system (BioMerieux ) and identified by VITEK-2 (BioMerieux). Epi Info Software system was used to calculate statistics.</p><p><strong>Results</strong>: One seventy (65.9%) were culture positive and 88 (34.1%) were culture negative out of 258 clinically suspected cases. Methicillin sensitive Staphylococcus aureus (MSSA) 66 (38.82%) was the commonest organism. Among 88 culture negative cases, 38(43.2%) babies were two or more sepsis screen tests positive, 40(45.5%) culture negative babies were with risk factors and 5(5.7%) had radiological evidence of pneumonia.</p><p><strong>Conclusion</strong>: The clinical diagnosis of it remains difficult as the symptoms are nonspecific. So, blood culture is mandatory. Other diagnostic tests also help in this situation. Blood culture is still the "Gold standard" for the diagnosis of septicaemia in neonates, but culture negativity cannot exclude the sepsis as a whole.</p>

scholarly journals Comparison of Typhidot IgM test and blood culture in children with clinically compatible enteric fever

2018 ◽  
Vol 5 (6) ◽  
pp. 2129
Author(s):  
Sandeep Garg ◽  
Ajay Sankhe ◽  
Anuradha Joshi ◽  
Samrat Mehta
Keyword(s):  
Blood Culture ◽  
Observational Study ◽  
Enteric Fever ◽  
Early Stage ◽  
Antibiotic Administration ◽  
Highly Sensitive ◽  
Culture Sensitivity ◽  
Low Sensitivity ◽  
Culture Positive ◽  
Culture Negative

Background: The often-non-specific presentation of typhoid fever makes clinical diagnosis difficult. The blood culture is time consuming, affected by often given prior antibiotics and has low sensitivity (60%). Typhidot IgM gives quick results in early stage of disease. Pediatric data are scarce. So, we studied and compare Typhidot IgM test and blood culture in children with clinically compatible enteric fever.Methods: This was retrospective observational study done in Department of Pediatrics from the 1st October, 2017 to 30 September, 2018. 42 children with clinically compatible enteric fever (aged 6 months to 18 years); with either typhidot IgM or blood culture positive for Salmonella species were sampled and analyzed.Results: Typhidot IgM test had sensitivity of 92.7% (N = 39/42) compared to blood culture with sensitivity of 79.4% (N = 27/34). 2 out of 3 typhidot negative cases were S. Paratyphi positive in blood culture. Typhidot IgM had positive predictive value = 97.4% due to 1 false positive case. 19 (79.2%) out of 24 blood culture positive patients had not received any antibiotic prior test, 3 (60 %) out of 5 blood culture negative patients had received antibiotics.Conclusions: Typhidot IgM is a highly sensitive quick diagnostic tool for diagnosing enteric fever in children with sensitivity of 92.3% and PPV of 97.4% compared to blood culture (sensitivity= 79.4%). It is more sensitive to diagnose S. typhi enteric fever (sensitivity= 97.3%) then S. paratyphi (sensitivity= 50%). Antibiotic administration prior to blood culture testing reduces its positivity rate but not significantly statistically. Larger studies are needed to change the current recommendations on typhidot IgM.

scholarly journals Comparison of outcome between blood culture positive and negative infective endocarditis patients undergoing cardiac surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kristians Meidrops ◽  
Arina Zuravlova ◽  
Janis Davis Osipovs ◽  
Martins Kalejs ◽  
Valerija Groma ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Multivariate Analyses ◽  
Statistical Significance ◽  
Delayed Diagnosis ◽  
Causative Microorganism ◽  
Independent Association ◽  
Culture Positive ◽  
Culture Negative

Abstract Background Up to 30% or even more of all infective endocarditis (IE) cases are recognized as blood culture negative, meaning that the causative agent is left unidentified. The prompt diagnosis together with the identification of causative microorganism and targeted antibiotic treatment can significantly impact the prognosis of the disease and further patient’s health status. In some studies, blood culture negative endocarditis has been shown to be associated with delayed diagnosis, worse outcome and course of the disease, and a greater number of intra and postoperative complications. Methods We retrospectively analysed the medical records of all patients who underwent cardiac surgery for endocarditis between years 2016 and 2019. The aim of this study was to analyse short and long-term mortality and differences of laboratory, clinical and echocardiography parameters in patients with blood culture positive endocarditis (BCPE) and blood culture negative endocarditis (BCNE) and its possible impact on the clinical outcome. Results In our study population were 114 (55.1%) blood culture positive and 93 (44.9%) blood culture negative cases of infectious endocarditis. The most common pathogens in the blood culture positive IE group were S.aureus in 36 cases (31.6%), Streptococcus spp. in 27 (23.7%), E.faecalis in 24 (21.1%), and other microorganisms in 27 (23.7%). Embolic events were seen in 60 patients (28.9%). In univariate analyses, detection of microorganism, elevated levels of procalcitonin were found to be significantly associated with intrahospital death, however it did not reach statistical significance in multivariate analyses. Among microorganisms, S.aureus was significantly associated with intrahospital death in both univariate and multivariate analyses. Conclusions There are no statistically significant differences between groups of BCPE and BCNE in terms of intrahospital mortality, hospital and ICU stay or 3-year mortality. There were higher levels of procalcitonin in BCPE group, however procalcitonin failed to show independent association with mortality in multivariate analysis. The most common microorganism in the BCPE group was S.aureus. It was associated with independently higher intrahospital mortality when compared to other causative microorganisms.

Next-generation Diagnostics for Melioidosis: Evaluation of a Prototype i-STAT Cartridge to Detect Burkholderia pseudomallei Biomarkers

2018 ◽  
Vol 69 (3) ◽  
pp. 421-427 ◽  
Author(s):  
Kevin L Schully ◽  
Charles C Young ◽  
Mark Mayo ◽  
Amy L Connolly ◽  
Vanessa Rigas ◽  
...  
Keyword(s):  
Blood Culture ◽  
Burkholderia Pseudomallei ◽  
High Sensitivity ◽  
Diagnostic Tools ◽  
Next Generation ◽  
Blood Samples ◽  
Life Threatening ◽  
Low Sensitivity ◽  
Culture Positive ◽  
Culture Negative

AbstractBackgroundInfection with the gram-negative bacterium Burkholderia pseudomallei can result in melioidosis, a life-threatening disease that can be difficult to diagnose. Culture remains the gold standard for diagnosis but requires laboratory resources not available in many endemic regions. A lateral flow immunoassay has shown promise for POC diagnostics but suffers from low sensitivity when used on blood samples. PCR also has low sensitivity on blood, attributed to the low bacterial numbers in blood observed in melioidosis patients, even when bacteraemic.MethodsA prototype i-STAT cartridge was developed to utilize the monoclonal antibody specific for the capsule of pathogenic Burkholderia species employed on the LFI. The resulting POC assay was evaluated on 414 clinical specimens from Darwin, Australia and Cambodia.ResultsThe i-STAT assay accurately distinguished Australian blood culture positive melioidosis patients from Australian patients hospitalized with other infections (AUC = 0.91, 95% CI 0.817 - 1.0). We derived an assay cutoff with 76% sensitivity and 94% specificity that correctly classified 88% (n = 74) of the Australian patients. Interestingly, only 46% (6/13) of the culture-positive melioidosis patients in Cambodia were classified correctly. Of great importance however, the assay detected capsule from blood samples for 32% of blood culture negative melioidosis patients in both cohorts and previously undiagnosed melioidosis patients in Cambodia. In addition the assay showed high sensitivity and specificity for urine, pus and sputum.ConclusionsDiagnostic tools that are not dependent upon the growth kinetics or the levels of bacteremia of B. pseudomallei represent the next-generation of diagnostics and must be pursued further.

Prognostic Value Of Blood Cultures as an Illness Severity Marker In Emergency Medical Admissions

2020 ◽  
Vol 19 (2) ◽  
pp. 83-89
Author(s):  
Richard Conway ◽  
◽  
Brian O’Connell ◽  
Declan Byrne ◽  
Deirdre O’Riordan ◽  
...  
Keyword(s):  
Blood Culture ◽  
Prognostic Value ◽  
Positive Culture ◽  
Illness Severity ◽  
Blood Cultures ◽  
Multivariable Logistic Regression Model ◽  
Negative Culture ◽  
Culture Performance ◽  
Culture Positive ◽  
Culture Negative

Background: Positive blood cultures predict mortality. The prognostic value of blood culture performance itself has not been fully defined. Methods: We evaluated medical admissions from 2002-2017. We defined blood culture category as 1) no culture 2) negative culture 3) positive culture. We employed a multivariable logistic regression model to evaluate outcomes. Results: We evaluated 78,568 blood cultures in 106,586 admissions. 30-day in-hospital mortality for no culture was 2.8% (95%CI 2.7, 2.9), culture negative 8.9% (95%CI 8.5, 9.3) and culture positive 16.7% (95%CI 15.5, 17.9). There was significant interaction between blood culture category and illness severity, OR 1.06 (95%CI 1.05, 1.08), and comorbidity, OR 1.09 (95%CI 1.09, 1.10). Conclusion: Performance and results of blood cultures are independently associated with increased mortality.

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