Skip to main content

Advertisement

SpringerLink
Log in

Follow-up blood cultures in E. coli and Klebsiella spp. bacteremia—opportunities for diagnostic and antimicrobial stewardship

  • Brief Report
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Uncomplicated Enterobacteriaceae bacteremia is usually transient and may not require follow-up blood cultures (FUBC). This is a retrospective observational study conducted at a university-affiliated urban teaching hospital in Seattle, WA. All patients ≥ 18 years hospitalized between July 2014 and August 2019 with ≥ 1 positive blood culture for either Escherichia coli or Klebsiella species were included. The primary outcome was to determine the number and frequency of FUBC obtained, and the detection rate for positive FUBC. There were 335 episodes of E. coli and Klebsiella spp. bacteremia with genitourinary (54%) being the most common source. FUBC were sent in 299 (89.3%) patients, with a median of 3 (interquartile range (IQR): 2, 4) sets of FUBC drawn per patient. Persistent bacteremia occurred in 37 (12.4%) patients. In uncomplicated E. coli and Klebsiella spp. bacteremia, when the pre-test probability of persistent bacteremia is relatively low, FUBC may not be necessary in the absence of predisposing factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Seifert H (2009) The clinical importance of microbiological findings in the diagnosis and management of bloodstream infections. Clin Infect Dis 48(Suppl 4):S238–S245

    Article  Google Scholar 

  2. Coburn B, Morris AM, Tomlinson G, Detsky AS (2012) Does this adult patient with suspected bacteremia require blood culture? JAMA 308(5):502–511

    Article  CAS  Google Scholar 

  3. Wiggers JB, Xiong W, Daneman D (2016) Sending repeat cultures: is there a role in the management of bacteremic episodes? BMC Infect Dis 16:286–295

    Article  Google Scholar 

  4. Canzoneri CN, Akhavan BJ, Tosur Z et al (2017) Follow-up blood cultures in Gram-negative bacteremia: are they needed? Clin Infect Dis 65(11):1776–1779

    Article  Google Scholar 

  5. Jung J, Song KH, Jun KI et al (2020) Predictive scoring models for persistent gram-negative bacteremia that reduce the need for follow-up blood cultures: a retrospective observational cohort study. BMC Infect Dis 20:680–689

    Article  CAS  Google Scholar 

  6. Kang CK, Kim ES, Song KH et al (2013) Can a routine follow-up blood culture be justified in Klebsiella pneumoniae bacteremia? A retrospective case-control study. BMC Infect Dis 13(1):365–371

    Article  Google Scholar 

  7. Mitaka H, Gomez T, Lee YI, Perlman DC (2020) Risk factors for positive follow-up blood cultures in Gram-negative bacilli bacteremia: implications for selecting who needs follow-up blood cultures. Open Forum Infect Dis 7(4):ofaa110. https://doi.org/10.1093/ofid/ofaa110

    Article  PubMed  PubMed Central  Google Scholar 

  8. Shi H, Kang CI, Cho SY et al (2019) Follow-up blood cultures add little value in management of bacteremic urinary tract infections. Eur J Clin Microbiol Infect Dis 38:695–702

    Article  Google Scholar 

  9. Chen AI, Bilker WB, Hamilton KW (2018) Blood culture utilization at an academic hospital: addressing a gap in benchmarking. Infect Control Hosp Epidemiol 39:1353–1359

    Article  Google Scholar 

  10. Wiggers JB, Daneman N (2020) The culture of follow-up blood cultures. Clin Microbiol Infect 26(7):811–813

    Article  CAS  Google Scholar 

  11. Maskarinec SA, Park LP, Ruffin NA et al (2020) Positive follow-up blood cultures identify high mortality risk among patients with Gram-negative bacteremia. Clin Microbiol Infect 26(7):904–910

    Article  CAS  Google Scholar 

  12. Giannella M, Pascale R, Pancaldi L et al (2020) Follow-up blood cultures are associated with improved outcome of patients with gram-negative bloodstream infections: retrospective observational cohort study. Clin Microbiol Infect 26(7):897–903

    Article  CAS  Google Scholar 

  13. Spaziante M, Oliva A, Ceccarelli G et al (2020) Follow-up blood cultures in Gram-negative bacilli bacteremia: are they needed for critically ill patients? Minerva Anestesiol 86(5):498–506

    Article  Google Scholar 

  14. Bates DW, Goldman L, Lee TH (1991) Contaminant blood cultures and resource utilization: the true consequences of false-positive results. JAMA 265(3):365–369

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pharmacy, Harborview Medical Center, and School of Pharmacy, University of Washington, 325 Ninth Avenue, Box 359885, Seattle, WA, 98104, USA

    Jeannie D. Chan & Ashley Ta

  2. Department of Medicine, Division of Allergy & Infectious Diseases, School of Medicine, University of Washington, Seattle, WA, USA

    Jeannie D. Chan, John B. Lynch & Chloe Bryson-Cahn

Authors
  1. Jeannie D. Chan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashley Ta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John B. Lynch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chloe Bryson-Cahn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeannie D. Chan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chan, J.D., Ta, A., Lynch, J.B. et al. Follow-up blood cultures in E. coli and Klebsiella spp. bacteremia—opportunities for diagnostic and antimicrobial stewardship. Eur J Clin Microbiol Infect Dis 40, 1107–1111 (2021). https://doi.org/10.1007/s10096-020-04141-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-020-04141-x

Keywords

Search

Navigation