scholarly journals 908. Evaluation of Blood Culture Submission Rates in Japan

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S487-S488
Author(s):  
Taichi Tajima ◽  
Shinya Tsuzuki ◽  
Yusuke Asai ◽  
Mio Endo ◽  
Nobuaki Matsunaga ◽  
...  
Keyword(s):  
Blood Culture ◽  
Bloodstream Infection ◽  
Hospital Setting ◽  
Bloodstream Infections ◽  
Median Number ◽  
Antimicrobial Treatment ◽  
Blood Cultures ◽  
Significant Difference ◽  
Acute Hospitals ◽  
Median Incidence

Abstract Background Blood culture tests are useful for accurate diagnosis of bacteremia and selection of antimicrobial treatment, and they are essential for instituting antimicrobial resistance (AMR) countermeasures. This study investigated blood culture submission rates in Japan and their association with the incidence of bloodstream infections. Methods Blood culture data recorded in the Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) database from January to December 2019 and data submitted for consecutive 12 months from acute care hospitals (hospitals with a mean length of patient stay of ≤19 days) were included for analysis. Samples comprised 1 set of blood culture samples (aerobic and anaerobic bottles) defined as one submission. The annual blood culture submission rate was calculated as the total number of submitted blood cultures per 1000 patients/day. The incidence of bloodstream infections was calculated as the number of positive blood cultures excluding contaminated specimens per 1000 patients/day. The blood culture submission rate was then divided into four categories, respectively: category 1: 0–15; category 2: 15–30; category 3: 30–45; and category 4: 45–80. The Kruskal-Wallis test was performed to determine overall difference among 4 submission rate categories and the Dunn test with Bonferroni correction was used to compare pairs of submission rate categories. Filtering of facilities for data analysis Results A total of 117 hospitals were included in the analysis. The median number of beds was 415.0 (interquartile ratio [IQR]: 274.5–549.5). The median incidence of bloodstream infection was 2.78 (2.17–3.87). The median blood culture submission rate was 26.18 (17.20–35.76). The median incidence of bloodstream infection by category of blood culture submission rate was 1.39, 2.53, 3.61, and 4.48, respectively; with a significant difference observed among the four categories overall (p< 0.01). Significant differences were observed between categories 1 and 2 and between categories 2 and 3 (both p< 0.01) but not between categories 3 and 4 (p=0.758). Characteristics of the acute hospitals by category of blood culture submission rate Incidence of bloodstream infections by category of blood culture submission rate Conclusion The blood culture submission rate is considered to be around 45 in the acute hospital setting in Japan. The incidence of bloodstream infections is greatly affected by submission rates. Disclosures All Authors: No reported disclosures

scholarly journals Rapid Rule Out of Culture-Negative Bloodstream Infections by Use of a Novel Approach to Universal Detection of Bacteria and Fungi

2019 ◽  
Vol 3 (4) ◽  
pp. 534-544 ◽  
Author(s):  
Andrew J Rogers ◽  
Daniel S Lockhart ◽  
Rebecca Clarke ◽  
Helen V Bennett ◽  
Yassar Kadoom ◽  
...  
Keyword(s):  
Blood Culture ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Culture Bottle ◽  
Detection Range ◽  
Overnight Incubation ◽  
Number Of Patients ◽  
Bacteria And Fungi ◽  
Rule Out

Abstract Background Currently it can take up to 5 days to rule out bloodstream infection. With the low yield of blood cultures (approximately 10%), a significant number of patients are potentially exposed to inappropriate therapy that can lead to adverse events. More rapid rule out can accelerate deescalation or cessation of antimicrobial therapy, improving patient outcomes. Methods A method is described, termed enzymatic template generation and amplification (ETGA), that universally and sensitively detects DNA polymerase activity liberated from viable bacteria and fungi isolated from blood culture samples as a measure of bloodstream infection. ETGA was applied in a diagnostic test format to identify negative blood cultures after an overnight incubation. Performance data for a prototype (Cognitor) and automated (Magnitor) version of the test are presented. Results The Cognitor manual assay displayed analytical reactivity for a panel of the 20 most prevalent causes of bloodstream infection, with a detection range of 28–9050 CFU/mL. Validation with 1457 clinical blood cultures showed a negative predictive value of 99.0% compared to blood culture incubation for 5 days. Magnitor showed an improved detection range of 1–67 CFU/mL, allowing for detection of bacteria-supplemented blood cultures after 2–8 h incubation, and Candida albicans-supplemented blood cultures at 16–22 h, 5–15 h faster than blood culture. Removing an aliquot from a blood culture bottle and replacing the bottle into the incubator was shown not to result in contaminating organisms being introduced. Conclusions The described method displays excellent breadth and detection for microbial cells and demonstrates the capability of confirming negative blood cultures after an overnight incubation in a blood culture instrument.

Blood culture utilization at an academic hospital: Addressing a gap in benchmarking

2018 ◽  
Vol 39 (11) ◽  
pp. 1353-1359 ◽  
Author(s):  
Annie I. Chen ◽  
Warren B. Bilker ◽  
Keith W. Hamilton ◽  
Judith A. O’Donnell ◽  
Irving Nachamkin
Keyword(s):  
Blood Culture ◽  
Emergency Services ◽  
Tertiary Care ◽  
Hospital Setting ◽  
General Medicine ◽  
Positive Culture ◽  
Median Number ◽  
Blood Cultures ◽  
University Hospital ◽  
True Positive

AbstractObjectiveTo describe the pattern of blood culture utilization in an academic university hospital setting.DesignRetrospective cohort study.SettingA 789-bed tertiary-care university hospital that processes 40,000+blood cultures annually.MethodsWe analyzed blood cultures collected from adult inpatients at the Hospital of the University of Pennsylvania between July 1, 2014, and June 30, 2015. Descriptive statistics and regression models were used to analyze patterns of blood culture utilization: frequency of blood cultures, use of repeat cultures following a true-positive culture, and number of sets drawn per day.ResultsIn total, 38,939 blood culture sets were drawn during 126,537 patient days (incidence rate, 307.7 sets per 1,000 patient days). The median number of blood culture sets drawn per hospital encounter was 2 (range, 1–76 sets). The median interval between blood cultures was 2 days (range, 1–71 days). Oncology services and cultures with gram-positive cocci were significantly associated with greater odds of having repeat blood cultures drawn the following day. Emergency services had the highest rate of drawing single blood-culture sets (16.9%), while oncology services had the highest frequency of drawing ≥5 blood culture sets within 24 hours (0.91%). Approximately 10% of encounters had at least 1 true-positive culture, and 89.2% of those encounters had repeat blood cultures drawn. The relative risk of a patient having repeat blood cultures was lower for those in emergency, surgery, and oncology services than for those in general medicine.ConclusionsOrdering practices differed by service and culture results. Analyzing blood culture utilization can contribute to the development of guidelines and benchmarks for appropriate usage.

scholarly journals 55. Impact of Testing Methodology and Reporting on Time to Preferred Antibiotic Therapy in Extended Spectrum Beta-Lactamase producing Enterobacteriaceae (ESBL-E) Bloodstream Infections

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S147-S147
Author(s):  
Hanh Bui ◽  
Frank Tverdek ◽  
Stephanie Carnes ◽  
Jeannie D Chan ◽  
Andrew Bryan ◽  
...  
Keyword(s):  
Blood Culture ◽  
Medical Center ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Definitive Therapy ◽  
Significant Difference ◽  
Carbapenem Antibiotic ◽  
Tof Ms

Abstract Background Harborview Medical Center (HMC) identifies organisms and an ESBL genotype (CTX-M) via Verigene® Gram-Negative Blood Culture Nucleic Acid Test (BC-GN). University of Washington-Montlake (UWML) uses matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) for organism identification directly from positive blood cultures and ceftriaxone results by Kirby Bauer disk diffusion (KB) are reported 18 hours later. No ESBL comment is reported at UWML. We aimed to determine whether the methodology in identification and reporting of ESBL-E from blood cultures between two hospitals has an impact on time to preferred therapy with a carbapenem antibiotic. Methods Retrospective observational study conducted at UWML and HMC in Seattle, WA between 1/10/2015 and 9/15/2020. Adult patients were eligible if they had ≥1 positive blood culture with an Enterobacteriaceae isolate resistant to ceftriaxone and were on antibiotic treatment. The primary outcome was the difference in time to preferred definitive therapy with a carbapenem antibiotic in patients an ESBL-E bloodstream infection (BSI) identified by Verigene® vs. MALDI-TOF MS/KB. Results A total of 199 patients were screened; 67 were included for UWML and 68 at HMC. The average time to initiation of a carbapenem antibiotic was 42 ±26.5 hours at UWML and 28 ±19.7 hours at HMC. A t-test detected a difference in time to preferred therapy between a Verigene® vs. MALDI-TOF MS/KB tested ESBL-E BSI [95% confidence interval (CI), 5.3-22.9]. The hazard ratio to carbapenem initiation for HMC is 1.73643 [95% CI, 1.1405-2.644]. Conclusion A statistically significant difference in time to preferred definitive therapy among patients with an ESBL-E BSI processed by Verigene® was found compared to MALDI-TOF MS. The results suggest standardization in protocols between the UWML and HMC hospitals is warranted. Disclosures Andrew Bryan, MD, PhD, Shionogi Inc. (Grant/Research Support)

“Blood Culture Utilization in the Hospital Setting: A Call for Diagnostic Stewardship”.

2021 ◽  
Author(s):  
Valeria Fabre ◽  
Karen C. Carroll ◽  
Sara E. Cosgrove
Keyword(s):  
Blood Culture ◽  
Hospital Setting ◽  
Bloodstream Infections ◽  
Culture Collection ◽  
Blood Cultures ◽  
Negative Consequences ◽  
Detection Systems ◽  
Molecular Tests ◽  
Collection Practices ◽  
Organism Identification

There has been significant progress in detection of bloodstream pathogens in recent decades with the development of more sensitive automated blood culture detection systems and availability of rapid molecular tests for faster organism identification and detection of resistance genes. However, most blood cultures in clinical practice do not grow organisms, suggesting that suboptimal blood culture collection practices (e.g., suboptimal blood volume) or suboptimal selection of patients to culture (i.e., blood cultures ordered for patients with low likelihood of bacteremia) may be occurring. A national blood culture utilization benchmark does not exist, nor do specific guidelines on when blood cultures are appropriate or when blood cultures are of low value and waste resources. Studies evaluating the potential harm associated with excessive blood cultures have focused on blood culture contamination which has been associated with significant increases in healthcare costs and negative consequences for patients related to exposure to unnecessary antibiotics and additional testing. Optimizing blood culture performance is important to ensure bloodstream infections (BSIs) are diagnosed while minimizing adverse events from overuse.

scholarly journals 75. Utility of Fungal Blood Cultures in Portland, Oregon

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S154-S155
Author(s):  
Sujeet Govindan ◽  
Luke Strnad
Keyword(s):  
Blood Culture ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Hematologic Malignancies ◽  
Blood Cultures ◽  
Biologic Agent ◽  
Systemic Steroid ◽  
High Dose ◽  
Inappropriate Use ◽  
History Of

Abstract Background Fungal blood cultures (fungal isolators) should be used, if at all, primarily for identification of mold infections. At our institution we noted patients having fungal blood cultures drawn in many other situations, including when the primary team was concerned for candida bloodstream infection. We sought to describe the utility of this practice and of fungal blood cultures in general. Methods We retrospectively reviewed the results of fungal blood cultures for 2 years, from 3/1/2019-3/1/2021. We evaluated the number of episodes, culture results, whether there was a had prior bloodstream infection, and risk factors for fungal infection including renal replacement (RRT), ECMO, and immunosuppression (IS). Immunosuppression was defined as chronic systemic steroid use, recent receipt of high dose steroids within 2 weeks, history of organ transplantation, history of stem cell transplantation, hematologic malignancies, or receipt of a biologic agent. Results 187 fungal blood cultures were drawn in 143 patients - 80 cultures in 70 patients from 3/2019-3/2020 and 107 cultures in 73 patients from 3/2020-3/2021. Only 3 patients had positive fungal blood cultures:1 (Candida krusei) from 3/2019-3/2020 and 2 (Candida albicans and Cyrptococcus neoformans) from 3/2020-3/2021; in all 3 cases the organism also grew from standard blood culture isolators. From 3/2019-3/2020, 1/80 cultures were drawn from an individual on ECMO while 15/80 were drawn from individuals on RRT, and 32/80 were in a IS individuals. From 3/2020-3/2021, 45/107 cultures were drawn from an individual on ECMO, 24/107 were drawn in an individual on RRT, and 73/107 were drawn in a IS individuals. The majority of individuals in whom a fungal blood culture was drawn during 3/2020-3/2021 were individuals with COVID-19. Upon chart review most of the cultures were drawn due to concern for candidemia. Results of fungal blood cultures drawn from 3/2019-3/2021 at OHSU Conclusion Fungal blood cultures have an extremely low yield at our institution, with a 1.6% positivity rate over a 2 year period, and all of those cultures were detected by standard blood culture isolators. Most of these cultures were drawn in situations where this test has no utility. Furthermore, the test has limited utility to detect dimorphic and mold bloodstream infections. Restriction of this test may limit inappropriate use. Disclosures All Authors: No reported disclosures

scholarly journals 1341. Blood Volume Collected for Blood Cultures in Infants with Suspected Neonatal Sepsis in the NICU

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S682-S682
Author(s):  
Maria S Rueda Altez ◽  
Lamia Soghier ◽  
Joseph M Campos ◽  
James Bost ◽  
Jiaxiang Gai ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Blood Volume ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Volume Calculation ◽  
Culture Negative ◽  
Time Of Collection ◽  
Rule Out

Abstract Background Blood cultures have high sensitivity to detect bacteremia in septic neonates when >=1 ml of blood is collected. Neonatologists often cite low confidence in microbiologic sampling as rationale for continuing antibiotics without a focus of infection despite negative blood cultures, resulting in prolonged antimicrobial therapy. We aim to describe the blood culture sample volumes in NICU patients, to identify factors associated with sample volumes < 1ml, and to compare the sample volumes of patients treated for culture-negative sepsis with those with bloodstream infections and those treated for a ≤72-hour sepsis rule-out Methods Data from this observational cohort study were collected retrospectively and prospectively from NICU patients with blood cultures obtained from September 2018 to February 2019. Clinical data were collected through chart review. All inoculated culture bottles were weighed for volume calculation. We determined the association of age, weight, sample source, and time of collection with volume < 1mL. Continuous variables were analyzed using Wilcoxon-Mann-Whitney, and categorical variables using chi-squared test. For aim 3, the volumes of the groups were compared using analysis of variance. Results A total of 310 blood cultures were identified, corresponding to 159 patients. Of these, 49 (16%) were positive. Among the negative blood cultures, 86% were collected in patients who subsequently received antibiotics (Figure 1). Median inoculated volume was 0.6 ml (IQR: 0.1-2.4). Weight and age at time of culture collection, source of sample, and time of collection were not significantly associated with the inoculation of < 1ml of blood. Median volume of blood was 0.6ml (0.3-0.6) for sepsis rule-out, 0.6ml (0.2-0.6) for bloodstream infection, and 0.6ml (0.6-1.4) for culture-negative sepsis. No difference was found among the three groups (p=0.54) Figure 1. Classification of blood cultures identified during study period Conclusion The blood volume collected for cultures in the NICU is lower than recommended. Clinical and environmental characteristics are not significantly associated with the inoculated volume. The volume of blood sampled does not differ in patients with culture-negative sepsis, bloodstream infection and sepsis rule-out, and should not be a justification for longer duration of antibiotic therapy Disclosures All Authors: No reported disclosures

scholarly journals Scanning Electron Microscope: A New Potential Tool to Replace Gram Staining for Microbe Identification in Blood Cultures

2021 ◽  
Vol 9 (6) ◽  
pp. 1170
Author(s):  
Gabriel Haddad ◽  
Sara Bellali ◽  
Tatsuki Takakura ◽  
Anthony Fontanini ◽  
Yusuke Ominami ◽  
...  
Keyword(s):  
Electron Microscope ◽  
Blood Culture ◽  
Scanning Electron Microscope ◽  
Sample Preparation ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Preliminary Identification ◽  
Gram Staining ◽  
Micro Organisms ◽  
Scanning Electron

Blood culture is currently the most commonly used method for diagnosing sepsis and bloodstream infections. However, the long turn-around-time to achieve microbe identification remains a major concern for clinical microbiology laboratories. Gram staining for preliminary identification remains the gold standard. We developed a new rapid strategy using a tabletop scanning electron microscope (SEM) and compared its performance with Gram staining for the detection of micro-organisms and preliminary identification directly from blood cultures. We first optimised the sample preparation for twelve samples simultaneously, saving time on imaging. In this work, SEM proved its ability to identify bacteria and yeasts in morphotypes up to the genus level in some cases. We blindly tested 1075 blood cultures and compared our results to the Gram staining preliminary identification, with MALDI-TOF/MS as a reference. This method presents major advantages such as a fast microbe identification, within an hour of the blood culture being detected positive, low preparation costs, and data traceability. This SEM identification strategy can be developed into an automated assay from the sample preparation, micrograph acquisition, and identification process. This strategy could revolutionise urgent microbiological diagnosis of infectious diseases.

scholarly journals Community-acquired bacteraemia in COVID-19 in comparison to influenza A and influenza B: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julinha M. Thelen ◽  
A. G. ( Noud) Buenen ◽  
Marjan van Apeldoorn ◽  
Heiman F. Wertheim ◽  
Mirjam H. A. Hermans ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Culture ◽  
The Netherlands ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Influenza A ◽  
Blood Cultures ◽  
Influenza B ◽  
Significant Difference ◽  
All Cause Mortality

Abstract Background During the coronavirus disease 2019 (COVID-19) pandemic in the Netherlands it was noticed that very few blood cultures from COVID-19 patients turned positive with clinically relevant bacteria. This was particularly evident in comparison to the number of positive blood cultures during previous seasonal epidemics of influenza. This observation raised questions about the occurrence and causative microorganisms of bacteraemia in COVID-19 patients, especially in the perspective of the widely reported overuse of antibiotics and the rising rate of antibiotic resistance. Methods We conducted a retrospective cohort study on blood culture results in influenza A, influenza B and COVID-19 patients presenting to two hospitals in the Netherlands. Our main outcome consisted of the percentage of positive blood cultures. The percentage of clinically relevant blood cultures, isolated bacteria and 30-day all-cause mortality served as our secondary outcomes. Results A total of 1331 viral episodes were analysed in 1324 patients. There was no statistically significant difference (p = 0.47) in overall occurrence of blood culture positivity in COVID-19 patients (9.0, 95% CI 6.8–11.1) in comparison to influenza A (11.4, 95% CI 7.9–14.8) and influenza B patients (10.4, 95% CI 7.1–13.7,). After correcting for the high rate of contamination, the occurrence of clinically relevant bacteraemia in COVID-19 patients amounted to 1.0% (95% CI 0.3–1.8), which was statistically significantly lower (p = 0.04) compared to influenza A patients (4.0, 95% CI 1.9–6.1) and influenza B patients (3.0, 95% CI 1.2–4.9). The most frequently identified bacterial isolates in COVID-19 patients were Escherichia coli (n = 2) and Streptococcus pneumoniae (n = 2). The overall 30-day all-cause mortality for COVID-19 patients was 28.3% (95% CI 24.9–31.7), which was statistically significantly higher (p = <.001) when compared to patients with influenza A (7.1, 95% CI 4.3–9.9) and patients with influenza B (6.4, 95% CI 3.8–9.1). Conclusions We report a very low occurrence of community-acquired bacteraemia amongst COVID-19 patients in comparison to influenza patients. These results reinforce current clinical guidelines on antibiotic management in COVID-19, which only advise utilization of antibiotics when a bacterial co-infection is suspected.

scholarly journals 48. Association of Rapid Pathogen Identification and Pharmacist Intervention on Time to Optimal Antimicrobial Therapy for Bloodstream Infections at Two Community Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Bryant M Froberg ◽  
Nicholas Torney
Keyword(s):  
Blood Culture ◽  
Hospital Mortality ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Pharmacist Intervention ◽  
Pathogen Identification ◽  
Community Hospitals ◽  
Significant Difference

Abstract Background As many as 1 in 3 patients with bloodstream infections at community hospitals receive inappropriate empiric antimicrobial therapy. Studies have shown that the coupling of real-time intervention with rapid pathogen identification improves patient outcomes and decreases health-system costs at large, tertiary academic centers. The aim of this study was to assess if similar outcomes could be obtained with the implementation of real-time pharmacist intervention to rapid pathogen identification at two smaller, rural community hospitals. Methods This was a pre-post implementation study that occurred from September of 2019 to March 2020. This study included patients ≥18 years of age admitted with one positive blood culture. Patients were excluded if they were pregnant, had a polymicrobial blood culture, known culture prior to admission, hospice consulted prior to admission, expired prior to positive blood culture, or transferred to another hospital within 24 hours of a positive blood culture. Endpoints of patients prior to intervention were compared to patients post-implementation. The primary endpoint was time to optimal antimicrobial therapy. Secondary endpoints included time to effective antimicrobial therapy, in-hospital mortality, length of hospital stay, and overall cost of hospitalization. Results Of 212 patients screened, 88 patients were included with 44 patients in each group. Both groups were similar in terms of comorbidities, infection source, and causative microbial. No significant difference was seen in the mean time to optimal antimicrobial therapy (27.3±35.5 hr vs 19.4± 30 hr, p=0.265). Patients in the post-implementation group had a significantly higher mean hospitalization cost ($24,638.87± $11,080.91 vs $32,722.07±$13,076.73, p=0.013). There was no significant difference in time to effective antimicrobial therapy, in-hospital mortality, or length of hospital stay. Conclusion There were no between-group differences in the primary outcome of time to optimal therapy, with a higher mean hospitalization cost after implementation. These results suggest further antimicrobial stewardship interventions are needed, along with larger studies conducted in the community hospital settings. Disclosures All Authors: No reported disclosures

scholarly journals Sepsis in cancer patients residing in Zimbabwe: Spectrum of bacterial and fungal aetiologies and their antimicrobial susceptibility patterns.

2019 ◽  
Author(s):  
FRANK CHINOWAITA ◽  
Wendy Chaka ◽  
Tinashe K Nyazika ◽  
Tendai C Maboreke ◽  
Inam Chitsike ◽  
...  
Keyword(s):  
Blood Culture ◽  
Cancer Patients ◽  
Antimicrobial Susceptibility ◽  
Methicillin Resistance ◽  
Antimicrobial Treatment ◽  
Blood Cultures ◽  
Gram Negative ◽  
E Coli ◽  
Patients With Cancer ◽  
Susceptibility Patterns

Abstract Introduction: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices. Methods: This was a descriptive cross sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively. Results: A total of 142 participants were enrolled; 50 (35.2%) had positive blood cultures with 56.0% gram positive, 42.0% gram negative bacteria and 2.0% yeast isolates. Most common isolates were Coagulase Negative Staphylococcus (CoNS) (22.0%), Escherichia coli (16.0%), Klebsiella pneumoniae (14.0%), Enterococcus faecalis (14.0%) and Staphylococcus aureus (8.0%) in all cancer patients. These isolates were similar in both haematological and solid cancers. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all gram negative isolates while vancomycin and linezolid were effective against 96.2% and 100.0% of all gram positive isolates respectively. Ten (66.7%) isolates of E. coli and K. pneumoniae were extended spectrum β-lactamase (ESBL) positive and the same proportion was observed on methicillin resistance among Staphylococcus species. Conclusions: The major microbial aetiologies of sepsis among patients with cancer in Zimbabwe were CoNS, E. coli, K. pneumoniae, E. faecalis and S. aureus. Most isolates were resistant to commonly used empirical antibiotics and there was high level of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.

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