A Study to Investigate Risk Factor for Enterococci Isolation from Bile and/or Blood Culture Obtained from Patients with Cholangitis

2017 ◽  
Vol 152 (5) ◽  
pp. S501
Author(s):  
Yuki Karasawa ◽  
Nobuo Toda ◽  
Junya Arai ◽  
Ken Kurokawa ◽  
Chikako Shibata ◽  
...  
Keyword(s):  
Risk Factor ◽  
Blood Culture ◽  
Investigate Risk Factor

scholarly journals Proposal for the use of echocardiography in bloodstream infections due to different streptococcal species

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandra Chamat-Hedemand ◽  
Niels Eske Bruun ◽  
Lauge Østergaard ◽  
Magnus Arpi ◽  
Emil Fosbøl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Bloodstream Infections ◽  
Low Risk ◽  
Moderate Risk ◽  
Streptococcal Species ◽  
Very High

Abstract Background Infective endocarditis (IE) is diagnosed in 7–8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. Methods In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk < 3%, moderate-risk 3–10%, high-risk 10–30% and very high-risk > 30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE > 10%), TTE (IE 3–10%), or “wait & see” (IE < 3%). Results We included 6393 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have ≥3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to “wait & see” strategy if they neither have a risk factor nor ≥3 positive BC bottles, while a TTE is recommended if they have either ≥3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor ≥3 positive BC bottles, but to TTE and TOE if they have either ≥3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. Conclusion In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography.

scholarly journals Comparison of the Contamination Rate and Risk Factor Profile of Blood Culture Done in Emergency Department and MHDU/MICUs

2021 ◽  
pp. 1-8
Author(s):  
Dr. Pankaj Kumar Singh
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Risk Factor ◽  
Blood Culture ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Contamination Rate ◽  
Medical Illness ◽  
Inclusion Criteria ◽  
Factors Associated

Aims and objectives: To determine the risk factors of blood culture contamination done in ED and those done in the MHDU/MICU among patients admitted with medical illness. Material and Methods: This is a two months’ prospective observational study comparing blood culture contamination rate and risk factors associated with contamination between ED and MICU/MHDU. A total of 998 patients were included in the study who underwent blood culture in ED and MICU/MHDU. 570 in ED and 428 in MICU/MHDU were included after meeting exclusion and inclusion criteria. Results: Blood culture growths were higher in ED (19%). Most common growth was CoNS (4%). The overall contamination rate in this study was (4.8%) The contamination rate was lower in ED (4.4%) when compared to MICU/MHDU (5.4%).

scholarly journals Is Low Hemoglobin Level a Risk Factor for Acute Lower Respiratory Tract Infections?

2009 ◽  
Vol 30 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Tejesh Malla ◽  
Om K Pathak ◽  
Kalpana K Malla
Keyword(s):  
Risk Factor ◽  
Iron Deficiency ◽  
Blood Culture ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hemoglobin Level ◽  
Control Group ◽  
Study Group ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Objective: This prospective study was conducted to evaluate whether a low hemoglobin level, was a risk factor for Acute Lower Respiratory Tract Infections (ALRTI) in children.   Methods: 150 Children of all age groups who came to the outpatient department and those admitted for ALRTI were included in the study. Age and sex-matched 140 children, not having any respiratory illness, were taken as control. The study period was from March 2006 - March 2007. Detailed clinical and laboratory evaluation of the enlisted patients was done. All were subjected to detail investigations.   Results: Radiological evidence of pneumonia was present in 70 (50 %) children.Hyperinflated lungs were seen in 40 (29%) and was normal in 30 (21.4%) cases. Blood culture was positive in 14 (10%) children of study group and none among control group. Klebsiella was the commonest organism isolated 6 (4.2%) in blood culture positive cases. The mean Hemoglobin (Hb) level of study group was 9.88 gm% and it was 12 gm% in control group.96 (68.6%) of study group and 30 (21.42%) of control group had anemia. Of the anemic children, 79 (82.3%) in study group had iron deficiency, and 17 (17.7%) had normocytic normochromic anemia. These values were 18 (33.3%) and 36 (66.6%) respectively for control group. Low hemoglobin level was a risk factor (p<0.001) ALRTI.   Conclusion: Anemic children were 3.2 times more susceptible to ALRTI compared to the control group and and iron deficiency anemia was predominating. Supplemental iron therapy may reduce the incidence of ALRTI. Prevention of anemia, due to whatever etiology is also essential. Key words: ALRTI, anemia, hemoglobin. DOI: 10.3126/jnps.v30i1.2453 Journal of Nepal Paediatric Society Vol.30(1) 2010 1-7  

scholarly journals Presepsin level as risk factor for mortality in premature infants with neonatal sepsis

2021 ◽  
Vol 61 (3) ◽  
pp. 165-70
Author(s):  
Muhammad Ifan Romli ◽  
Tetty Yuniati ◽  
Dany Hilmanto
Keyword(s):  
Risk Factor ◽  
Blood Culture ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Sepsis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Observational Prospective Cohort Study ◽  
Early Biomarker ◽  
Receiver Operator Characteristics

Background Prematurity is a risk factor of neonatal sepsis and its associated morbidities and mortality. Most deaths in neonatal sepsis occur within the first seven days. Presepsin has been reported as one of the earliest biomarkers for predicting mortality. Objective To determine the association between presepsin levels and mortality risk, as well as the optimal presepsin cut-off point for predicting mortality, in premature infants with neonatal sepsis .Method This was an observational prospective cohort study on 62 preterm infants born at 28 to <37 weeks’ gestation. We recorded clinical and laboratory characteristics, performed blood culture, and measured presepsin levels at initial diagnosis of sepsis. Subjects were followed for seven days and their outcome (death or survival) recorded. We evaluated the association between clinical and laboratory characteristics, including presepsin levels, with sepsis outcome. We also constructed a receiver-operator characteristics curve to determine the optimal cut-off point of presepsin as a predictor of sepsis mortality. Results Only blood culture results (P=0.006) and presepsin level (P<0.001) were significantly associated with sepsis outcome on the seventh day. The optimal presepsin cut-off value for predicting mortality was 1057 ng/mL, with an area under curve of 80.4%, sensitivity of 60.71%, and specificity of 88.24%. A presepsin level of >1057 ng/mL was associated with increased mortality [RR 3.02; 95%CI  68.3 to 89.4; P<0.001]. Conclusion In preterm infants with neonatal sepsis, an elevated presepsin level at diagnosis is a significant risk factor for mortality within seven days. Presepsin can be used as an early biomarker of sepsis outcome.

scholarly journals 2278. Emergence of Resistance and Associated Mortality during Persistent Pseudomonas aeruginosa Bacteremia in Hematopoietic Cell Transplant Recipients and Hematologic Malignancy Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S780-S780
Author(s):  
Lauren Fontana ◽  
Morgan Hakki
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Hematologic Malignancy ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Persistent Bacteremia ◽  
Emergence Of Resistance

Abstract Background Pseudomonas aeruginosa (PSA) bacteremia causes significant mortality in patients with hematologic malignancies (HM) and hematopoietic cell transplant (HCT) recipients in part due to intrinsic and acquired resistance mechanisms. However, the incidence of developing resistance on therapy and the associated outcomes are poorly described. We characterize the emergence of resistance on therapy and describe the outcomes of PSA bacteremia in this population. Methods We conducted a retrospective review of adults with HM and HCT recipients who developed PSA bacteremia between January 2012 and April 2018. A bacteremic episode was characterized as ≤ 14 days from the first positive blood culture. Persistent bacteremia was defined as a positive blood culture ≥ 72 hours of appropriate antibiotic therapy. Susceptibility testing was performed with VITEK2. Isolates were classified as “sensitive,” “intermediate,” or “resistant” per standard criteria; “intermediate” and “resistant” results were considered “non-susceptible.” Results 66 episodes of PSA bacteremia occurred in 59 patients. Among episodes in which a patient survived for ≥3 days, 8 (12.1%) met criteria for persistent bacteremia. Non-susceptibility to therapy developed in 5 of 7 episodes (71.4%) of persistent bacteremia; 1 did not have susceptibilities performed on both isolates. Patients with persistent bacteremia had a second positive blood culture within a median of 3.5 days. A concomitant visceral nidus of infection (pneumonia = 6, soft tissue = 1) (P = 0.005) was identified as the primary risk factor for persistent bacteremia. Risk factors for emergence of non-susceptibility could not be determined due low number of events. Infection associated mortality (IAM) (death ≤ 14 days) occurred in 12 (17.1%) of all episodes and 6 of 8 (75%) of persistent bacteremia. Persistent bacteremia was the only risk factor associated with IAM (P = 0.0002, RR 7.3). Conclusion Emergence of resistance to anti-Pseudomonal β-lactam antibiotics frequently occurs during treatment for persistent PSA bacteremia in HCT recipients and HM patients. Persistent bacteremia is associated with a visceral nidus of infection and was the only independent predictor of IAM. Disclosures All authors: No reported disclosures.

scholarly journals Education of medical personnel optimizes filling volume of blood culture bottles without negatively affecting microbiology testing

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Katrin Steiner ◽  
Joanna Baron-Stefaniak ◽  
Alexander M. Hirschl ◽  
Wolfgang Barousch ◽  
Birgit Willinger ◽  
...  
Keyword(s):  
Risk Factor ◽  
Blood Culture ◽  
Educational Intervention ◽  
Medical Personnel ◽  
Sample Volume ◽  
Blood Cultures ◽  
Adverse Outcomes ◽  
Filling Volume ◽  
Aerobic And Anaerobic ◽  
Blood Volumes

Abstract Background Anemia is a risk factor for adverse outcomes, which can be aggravated by unnecessary phlebotomies. In blood culture testing, up to 30 ml of blood can be withdrawn per sample, even though most manufacturers recommend blood volumes of 10 ml or less. After assessing the filling volume of blood culture bottles at our institution, we investigated whether an educational intervention could optimize filling volume of blood culture bottles without negatively affecting microbiology testing. Methods We weighed 10,147 blood cultures before and 11,806 blood cultures after a six-month educational intervention, during which employees were trained regarding correct filling volume via lectures, handouts, emails, and posters placed at strategic places. Results Before the educational intervention, only 31% of aerobic and 34% of anaerobic blood cultures were filled correctly with 5–10 ml of blood. The educational intervention increased the percentage of correctly filled bottles to 43% (P < 0.001) for both aerobic and anaerobic samples without negatively affecting results of microbiologic testing. In addition, sample volume was reduced from 11.0 ± 6.5 to 9.4 ± 5.1 ml (P < 0.001) in aerobic bottles and from 10.1 ± 5.6 to 8.8 ± 4.8 ml (P < 0.001) in anaerobic bottles. Conclusion Education of medical personnel is a simple and effective way to reduce iatrogenic blood loss and possibly moderate the extent of phlebotomy-induced anemia.

scholarly journals Bacteremia as a risk factor for variceal upper gastrointestinal tract bleeding in cirrhotic patients: a hospital-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mohamad Husseini Saeid Zidan ◽  
Sahar Gouda Zaghloul ◽  
Waseem Mohamed Seleem ◽  
Hanan Samir Ahmed ◽  
Ahmed Ibrahim Gad
Keyword(s):  
Risk Factor ◽  
Gastrointestinal Tract ◽  
Blood Culture ◽  
Variceal Bleeding ◽  
Upper Gastrointestinal Tract ◽  
Cutoff Value ◽  
Group I ◽  
Cirrhotic Patients ◽  
Gastrointestinal Tract Bleeding ◽  
Upper Gastrointestinal

Abstract Background The presence of bacteremia as a complication of variceal bleeding in patients with liver cirrhosis had been investigated by many studies. The aim of this study was to assess the bacteremia as a risk factor for variceal upper gastrointestinal tract bleeding in cirrhotic patients. A cross-sectional study was conducted on 99 patients with chronic liver disease divided into three groups: group I included 35 patients presented with first attack of variceal bleeding, group II included 35 patients presented with recurrent attacks of variceal bleeding, and group III included 29 patients with no history of previous variceal bleeding as a control group. Routine laboratory tests were done, upper GI endoscopy, blood culture, and measurement of procalcitonin level in blood. Results Patients with recurrent variceal bleeding had statistically (p < 0.05) the highest percentage of positive blood culture followed by patients with first variceal bleeding and the control (60% vs 45.7% vs 24.1%) respectively. In addition to procalcitonin results, patients with recurrent variceal bleeding had statistically the highest values of PCT followed by patients with first variceal bleeding and the control (1.92 vs 0.325 vs 0.22 ng/ml) respectively. Multivariate regression analysis showed that procalcitonin and hemoglobin only was the significant predictors for variceal bleeding. Hemoglobin at cutoff value of ≤ 9.6 and procalcitonin (ng/dl) at cutoff value of > 1.76 is the most specific in predicting bleeding 86.21%, 86.21% (CI 95%) respectively. Conclusion Bacteremia and procalcitonin are risk factor for variceal bleeding in cirrhotic patients. Procalcitonin can be used as easily measurable and surrogate biomarker for bacteremia and variceal bleeding.

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