Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Articles online first > Minerva Anestesiologica 2020 Feb 25

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

 

Minerva Anestesiologica 2020 Feb 25

DOI: 10.23736/S0375-9393.20.14040-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Follow up blood cultures in Gram-negative bacilli bacteremia: are they needed for critically ill patients?

Martina SPAZIANTE 1, Alessandra OLIVA 1, 2, Giancarlo CECCARELLI 1, Francesco ALESSANDRI 3, Francesco PUGLIESE 3, Mario VENDITTI 1

1 Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy; 2 IRCCS INM Neuromed, Pozzilli, Isernia, Italy; 3 Department of Anesthesia and Intensive Care Medicine, “Sapienza” University of Rome, Rome, Italy


PDF


BACKGROUND: Gram-negative bacilli bacteremias (GNB-Bs) represent a major cause of morbidity and mortality in Intensive Care Unit (ICU) patients. Aim of this study was to investigate the role of follow-up blood cultures (FUBCs) and the clinical significance of persistent bacteremia (PB) in these settings.
METHODS: We retrospectively analyzed clinical data and outcome of GNB-Bs that occurred in ICU patients over a span of 1 year. In particular we sought information on development and clinical details of PB, defined as repeatedly positive FUBCs after ≥96h of appropriate antibiotic treatment and ≥48h after removal of endovascular devices.
RESULTS: Among 307 ICU patients, 69 (22.4%) developed 107 GNB-Bs. Out of these, 78 (73%) could be eventually analysed: 50/78 (64.1%) were non-PBs from 26 patients and 28/78 (35.9%) were PBs from 23 patients. Duration of fever and bacteremia, time to procalcitonin normalization and weaning from vasopressors were longer in episodes of PBs than non-PBs (p=0.04, p<0.001, p=0.02 and p=0.004 respectively). Primary bacteremia was more frequent in non-PBs than in PBs (29/50, 58% vs 3/28, 10.7%, p=0.0001), whereas septic thrombus infection (STI) was the source of infection in 14/28 (50%). Finally, clinical features and 30-day mortality did not differ between patients with PB and those who developed only non-PB episodes.
CONCLUSIONS: Among our ICU patients, more than one third of GNB-Bs for which FUBCs were performed resulted PB. This condition is often associated with the presence of STI; therefore, FUBCs seem useful for the optimal management of GNB in this clinical setting.


KEY WORDS: Gram-negative bloodstream infections; Follow-up blood cultures; Persistent bacteremia; Septic thrombus infection; ICU

inizio pagina