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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.

Publication ,  Journal Article
Weinstein, MP; Towns, ML; Quartey, SM; Mirrett, S; Reimer, LG; Parmigiani, G; Reller, LB
Published in: Clin Infect Dis
April 1997

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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Published In

Clin Infect Dis

DOI

ISSN

1058-4838

Publication Date

April 1997

Volume

24

Issue

4

Start / End Page

584 / 602

Location

United States

Related Subject Headings

  • Prospective Studies
  • Prognosis
  • Multivariate Analysis
  • Microbiology
  • Humans
  • Fungemia
  • Bacteremia
  • Adult
  • Adolescent
  • 3202 Clinical sciences
 

Citation

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Weinstein, M. P., Towns, M. L., Quartey, S. M., Mirrett, S., Reimer, L. G., Parmigiani, G., & Reller, L. B. (1997). 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, 24(4), 584–602. https://doi.org/10.1093/clind/24.4.584
Weinstein, M. P., M. L. Towns, S. M. Quartey, S. Mirrett, L. G. Reimer, G. Parmigiani, and L. B. Reller. “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 24, no. 4 (April 1997): 584–602. https://doi.org/10.1093/clind/24.4.584.

Published In

Clin Infect Dis

DOI

ISSN

1058-4838

Publication Date

April 1997

Volume

24

Issue

4

Start / End Page

584 / 602

Location

United States

Related Subject Headings

  • Prospective Studies
  • Prognosis
  • Multivariate Analysis
  • Microbiology
  • Humans
  • Fungemia
  • Bacteremia
  • Adult
  • Adolescent
  • 3202 Clinical sciences