Clinical factors associated with bloodstream infection at the emergency department.

Clinical factors associated with bloodstream infection at the emergency department.

Bloodstream infection, Bacteremia, Blood cultures, Rapid diagnosis, Emergency department

Background
Bloodstream infection (BSI) is a common urgent condition at the emergency department (ED). However, current
guidelines for diagnosis do not specify the juncture at which blood cultures should be taken. The decision
whether or not to obtain hemoculture is based solely upon clinical judgment and potential outcomes of
inappropriately ordered cultures. This study aimed to find clinical factors present on ED arrival that are predictive
of bloodstream infection.
Methods
This study was conducted retrospectively at the ED of a single tertiary care hospital in Thailand. We included
adult patients with suspected infection based on blood culture who were treated with intravenous antibiotics
during their ED visit. Independent positive predictors for positive blood culture were calculated by logistic
regression analysis.
Results
A total of 169,578 patients visited the ED during the study period, 12,556 (7.40%) of whom were suspected of
infection. Of those, 8177 met the study criteria and were categorized according to blood culture results (741
positive; 9.06%). Six clinical factors, including age over 55 years, moderate to severe CKD, solid organ tumor,
liver disease, history of chills, and body temperature of over 38.3 [degrees]C, were associated with positive blood
culture.
Conclusions
Clinical factors at ED arrival can be used as predictors of bloodstream infection

Pariwat Phungoen, Nunchalit Lerdprawat, Kittisak Sawanyawisuth, Verajit Chotmongkol, Kamonwon Ienghong and Sumana
Sumritrin

BMC Emergency Medicine

Mar. 12, 2021

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Indonesia

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