Number of blood cultures for BSI diagnosis
Abstract:
Objective: Our study aimed to evaluate the optimal and financially efficient numbers of blood cultures (BC) required in our chronic kidney disease (CKD) patients with suspected bloodstream infections (BSI).
Design: This is a prospective, cross-sectional study.
Place and duration of study: Department of Nephrology, The Kidney Center Post-Graduate-Training-Institute, Karachi from July 2020 to December 2020.
Methods: Single, two, or three BC were taken from CKD patients with suspected BSI within the first 24 hours and were incubated in the BACTEC 1050 CMBCS for five days. A positive culture was reported as per standard protocol.
Results: Four hundred and eighty-three BC sets were collected from 272 patients. A single set of BC was obtained from 111 (40.8%), two sets from 111 (40.8%), and three from 50 (18.4%) patients. BC from 93 patients showed growth of organisms in at least one set. Fifty-six (60.2%) episodes of BSI were detected with the first set, 34 (36.5%) with the second set, and 03 (3.2%) with the third set of BC. The detection rate of BSI was 60.2% with the first set, 97.7% with the first two sets, and 100% with the first three sets of BC. The most common source of infection was central line-associated bloodstream infection (CLABSI) (33.3%), followed by urinary tract (29%), lower respiratory tract infection (LRTI) (16%), and arteriovenous fistula (AVF) (7.5%). 93.5% episodes of BSI, were monomicrobial. The most common monomicrobial organism was methicillin-resistant Staphylococcus aureus (MRSA) (22.6%).
Conclusion: Two properly collected BC sets might be sufficient for an adequate diagnosis of BSI, in CKD patients especially in resource-limited settings.
Reference:
Anser F, Dhrolia M, Qureshi S, Nasir K, Qureshi R, Ahmad A. Comparison Between the Yield of Different Number of Blood Cultures in Chronic Kidney Disease Patients With Suspected Septicemia. Cureus. 2021 Dec 13;13(12):e20381. doi: 10.7759/cureus.20381. PMID: 35036213; PMCID: PMC8753586.