The American Journal of Medicine
Volume 123, Issue 9 , Pages 819-828 , September 2010

The Clinical and Prognostic Importance of Positive Blood Cultures in Adults

  • Brian C. Pien, MD

      Affiliations

    • Clinical Microbiology Laboratory, Duke University Medical Center, Durham, NC
    • Durham Veterans Affairs Medical Center, NC
    • ,
  • Punidha Sundaram, MD

      Affiliations

    • Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ
    • ,
  • Natalia Raoof, MD

      Affiliations

    • Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ
    • ,
  • Sylvia F. Costa, MD

      Affiliations

    • Clinical Microbiology Laboratory, Duke University Medical Center, Durham, NC
    • Department of Medicine, Duke University School of Medicine, Durham, NC
    • ,
  • Stanley Mirrett, MS

      Affiliations

    • Clinical Microbiology Laboratory, Duke University Medical Center, Durham, NC
    • ,
  • Christopher W. Woods, MD

      Affiliations

    • Durham Veterans Affairs Medical Center, NC
    • Department of Medicine, Duke University School of Medicine, Durham, NC
    • Department of Pathology, Duke University School of Medicine, Durham, NC
    • ,
  • L. Barth Reller, MD

      Affiliations

    • Clinical Microbiology Laboratory, Duke University Medical Center, Durham, NC
    • Department of Medicine, Duke University School of Medicine, Durham, NC
    • Department of Pathology, Duke University School of Medicine, Durham, NC
    • ,
  • Melvin P. Weinstein, MD

      Affiliations

    • Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ
    • Department of Pathology, Robert Wood Johnson Medical School, New Brunswick, NJ
    • Corresponding Author InformationRequests for reprints should be addressed to Melvin P. Weinstein, MD, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, New Brunswick, NJ 08901

References 

  1. Weinstein MP, Reller LB, Murphy JR, Lichtenstein KA. The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. I. Laboratory and epidemiologic observations. Rev Infect Dis. 1983;5:35–53
  2. 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
  3. Weinstein MP, Towns ML, Quartey SM, et al. 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. Clin Infect Dis. 1997;24:584–602
  4. Diekema DJ, Beekmann SE, Chapin KC, et al. Epidemiology and outcome of nosocomial and community-onset bloodstream infection. J Clin Microbiol. 2003;41:3655–3660
  5. Lark RL, Chenoweth C, Saint S, et al. Four year prospective evaluation of nosocomial bacteremia: epidemiology, microbiology, and patient outcome. Diagn Microbiol Infect Dis. 2000;38:131–140
  6. Lark RL, Saint S, Chenoweth C, et al. Four-year prospective evaluation of community-acquired bacteremia: epidemiology, microbiology, and patient outcome. Diagn Microbiol Infect Dis. 2001;41(1-2):15–22
  7. Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39:309–317
  8. Edmond MB, Wallace SE, McClish DK, et al. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clin Infect Dis. 1999;29:239–244
  9. Cockerill FR, Wilson JW, Vetter EA, et al. Optimal testing parameters for blood cultures. Clin Infect Dis. 2004;38:1724–1730
  10. Friedman ND, Kaye KS, Stout JE, et al. Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med. 2002;137:791–797
  11. Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30:633–638
  12. National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Susceptibility Testing, 14th informational supplement (M100-S14). Wayne, PA: National Committee for Clinical Laboratory Standards; 2004;
  13. Gilbert DN, Moellering RC, Eliopoulos GM, et al. The Sanford Guide to Antimicrobial Therapy. 34th edition. Sperryville, VA: Antimicrobial Therapy, Inc; 2004;
  14. Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 5th edition. Philadelphia: Elsevier; 2000;
  15. Kaplan JE, Benson C, Holmes KH, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep. 2009;58(RR-4):1–207quiz CE1-4
  16. Moran GJ, Krishnadasan A, Gorwitz RJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med. 2006;355:666–674
  17. King MD, Humphrey BJ, Wang YF, et al. Emergence of community-acquired methicillin-resistant Staphylococcus aureus USA 300 clone as the predominant cause of skin and soft-tissue infections. Ann Intern Med. 2006;144:309–317
  18. Seybold U, Kourbatova EV, Johnson JG, et al. Emergence of community-associated methicillin-resistant Staphylococcus aureus USA300 genotype as a major cause of health care-associated blood stream infections. Clin Infect Dis. 2006;42:647–656
  19. Kluger MJ, Kozak W, Conn CA, et al. The adaptive value of fever. In:  Mackowiak P editors. Fever: Basic Mechanisms and Management. Philadelphia: Lippincott-Raven Publishers; 1997;p. 255–266
  20. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348:1546–1554
  21. Esper AM, Moss M, Lewis CA, et al. The role of infection and comorbidity: Factors that influence disparities in sepsis. Crit Care Med. 2006;34:2576–2582
  22. Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Crit Care Med. 2006;34:15–21
  23. Shorr AF, Tabak YP, Killian AD, et al. Healthcare-associated bloodstream infection: a distinct entity? (Insights from a large U.S. database). Crit Care Med. 2006;34:2588–2595
  24. Crane SJ, Uslan DZ, Baddour LM. Bloodstream infections in a geriatric cohort: a population-based study. Am J Med. 2007;120:1078–1083
  25. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–383

 Funding: None.

 Conflict of Interest: None.

 Authorship: All authors had access to the data and a role in writing the manuscript.

 This research was supported in part by a grant from the Department of Veteran Affairs Special Fellowship Program in Health Services Research.

PII: S0002-9343(10)00395-5

doi: 10.1016/j.amjmed.2010.03.021

The American Journal of Medicine
Volume 123, Issue 9 , Pages 819-828 , September 2010

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