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Cited by 1,228

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The Clinical Significance of Positive Blood Cultures in the 1990s: A Prospective Comprehensive Evaluation of the Microbiology, Epidemiology, and Outcome of Bacteremia and Fungemia in Adults

Weinstein, Melvin P., Towns, Michael L., Quartey, Seth M., Mirrett, Stanley, Reimer, Larry G., Parmigiani, Giovanni, Barth Reller, L.·1997·Clinical Infectious Diseases
DOI 10.1093/clind/24.4.584
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Abstract

To assess changes since the mid-1970s, we reviewed 843 episodes of positive blood cultures in 707 patients with septicemia. The five most common pathogens were Staphylococcus aureus, Escherichia coli, coagulase-negative staphylococci (CNS), Klebsiella pneumoniae, and Enterococcus species. Although CNS were isolated most often, only 12.4% were clinically significant. Half of all episodes were nosocomial, and a quarter had no recognized source. Leading identifiable sources included intravenous catheters, the respiratory and genitourinary tracts, and intraabdominal foci. Septicemia-associated mortality was 17.5%. Patients who received appropriate antimicrobial therapy throughout the course of infection had the lowest mortality (13.3%). Multivariate analysis showed that age (relative risk [RR], 1.80), microorganism (RR, 2.27), source of infection (RR, 2.86), predisposing factors (RR, 1.98), blood pressure (RR, 2.29), body temperature (RR, 2.04), and therapy (RR, 2.72) independently influenced outcome. Bloodstream infections in the 1990s are notable for the increased importance of CNS as both contaminants and pathogens, the proportionate increase in fungi and decrease in anaerobes as pathogens, the emergence of Mycobacterium avium complex as an important cause of bacteremia in patients with advanced human immunodeficiency virus infection, and the reduction in mortality associated with infection.

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Authors
Weinstein, M. P., Towns, M. L., Quartey, S. M., Mirrett, S., Reimer, L. G., Parmigiani, G., & Barth Reller, L.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
1997-04
Volume
24
Issue
4
Pages
584-602
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/clind/24.4.584
OpenAlex
W1990050552
Cited by
1,228
References
0
FWCI
32.21
Type
journal article
Language
en
Open access
closed

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