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Implementation of Consensus Guidelines for the Follow-Up of Positive Blood Cultures

Published online by Cambridge University Press:  02 January 2015

Thomas Herchline  and
Sheila Gros
Thomas Herchline*
Affiliation:
Infectious Disease Section, Department of Internal Medicine, Keesler AFB, Mississippi
Sheila Gros
Affiliation:
Microbiology Section, Department of Pathology, Keesler Medical Center, Keesler AFB, Mississippi
*
4881 Sugar Maple Dr, Wright-Patterson AB, OH 45433
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Abstract

Objective:

Assess the effect and use of resources associated with implementation of a program for the systematic follow-up of positive blood cultures.

Design:

Prospective epidemiologic study.

Setting:

Tertiary-care military medical center.

Intervention:

All positive blood cultures (BC) were reported via E-mail to an infectious disease specialist as soon as growth was noted. This individual reviewed all Gram stains, clinical data, and antibiotic information on these patients.

Results:

From June 26, 1994, through January 25, 1995, there were 3,121 BCs drawn, of which 199 (6.4%) were positive from 145 episodes. Sixty-three episodes involved probable contaminants, and 82 episodes were considered true bacteremias. Six patients with true bacteremia died, two were transferred, and three were discharged within 24 hours of drawing the positive BC. Of the remaining 71 true bacteremias, 9 patients were on inadequate empiric therapy, as judged by the final organism susceptibilities. Changes in empiric therapy were recommended for five of the nine episodes and were implemented by the primary physicians in each case. Each of the changes resulted in improved coverage (as judged by the final identification and susceptibilities).

Conclusions:

This program has improved the quality of care at Keesler Medical Center at the cost of one additional hour of consultant time per week.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 1 , January 1997 , pp. 38 - 41
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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References

1. Gross, PA, Barrett, TL, Dellinger, EP, et al. Quality standard for the treatment of bacteremia. Infect Control Hosp Epidemiol 1994;15:189–192.CrossRefGoogle ScholarPubMed
2. Roberts, FJ, Geere, IW, Coldman, A. A three-year study of positive blood cultures, with emphasis on prognosis. Rev Infect Dis 1991;13:34–46.Google Scholar
3. Bryan, CS. Clinical implications of positive blood cultures. Clin Microbiol Rev 1989;2:329–353.CrossRefGoogle ScholarPubMed
4. Uzun, Ö, Akalin, E, Hayran, M, Ünal, S. Factors influencing prognosis in bacteremia due to gram-negative organisms: evaluation of 448 episodes in a Turkish university hospital. Clin Infect Dis 1992;15:866–873.Google Scholar
5. Setia, U, Gross, PA. Bacteremia in a community hospital. Arch Intern Med 1977;137:1698–1701.CrossRefGoogle Scholar
6. Weinstein, MP, Murphy, JR, Reller, LB, Lichtenstein, KA. The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults, II: clinical observations, with special reference to factors influencing prognosis. Rev Infect Dis 1983;5:54–70.Google Scholar
7. Martin, MA. Epidemiology and clinical impact of gram-negative sepsis. Infect Dis Clin North Am 1991;5:739–752.CrossRefGoogle ScholarPubMed
8. Hilf, M, Yu, VL, Sharp, J, Zuravleff, JJ, Korvick, JA, Muder, R. Antibiotic therapy for Pseudomonas aeruginosa in a prospective study of 200 patients. Am J Med 1989;87:540–546.CrossRefGoogle Scholar
9. Maki, D, Schuna, AA. A study of antimicrobial misuse in a university hospital. Am J Med Sci 1978;275:271–282.Google Scholar
10. Dunagan, WC, Woodward, RS, Medoff, G, et al. Antimicrobial misuse in patients with positive blood cultures. Am J Med 1989;87:253–259.Google Scholar