Volume 19 Supplement 1

35th International Symposium on Intensive Care and Emergency Medicine

Open Access

Risk factors for bacteremia in adult febrile patients in emergency settings

  • A Mikami1,
  • Y Natori1,
  • F Omata2 and
  • S Ishimatsu1
Critical Care201519(Suppl 1):P11

https://doi.org/10.1186/cc14091

Published: 16 March 2015

Introduction

Blood culture is a critical procedure for detecting potentially life-threatening bloodstream infections (BSI). At the same time, early diagnosis and appropriate treatment of BSI are the key factors in order to improve prognosis. The purpose of the current analysis was to identify risk factors for bacteremia in adult febrile patients in emergency settings.

Methods

We conducted a retrospective case-control study within a population of adult patients visiting the emergency department at a community hospital (St Luke's International Hospital, Tokyo, Japan) and who underwent two sets of blood culture testing between 2003 and 2012. Among a total of 13,582 patients, 1,322 (10%) were detected as bacteremia. We included in this study 179 randomly selected patients from the bacteremia group and 321 randomly selected patients from the negative blood culture group to serve as the comparison group. Multivariate logistic regression was used to evaluate the relationship between clinical characteristics factors and bacteremia.

Results

In a multivariate logistic regression model, a statistically significant independent effect was found for body temperature (BT) >38°C (OR = 2.58, 95% CI, 1.76 to 3.79, P < 0.001), systolic blood pressure (SBP) <100 mmHg (OR = 1.72, 95% CI, 1.11 to 2.65, P = 0.01), CRP >10 mg/dl (OR = 3.03, 95% CI, 2.05 to 4.49, P < 0.001) and PaCO2 <32 mmHg (OR = 2.3, 95% CI, 1.57 to 3.37, P < 0.001). Receiver operating characteristic curve analysis revealed an area under the curve value of 0.725 for differentiating patients with bacteremia from negative culture.

Conclusion

BT >38°C, SBP <100 mmHg, CRP >10 mg/dl and PaCO2 <32 mmHg are independently associated with bacteremia. These factors might be useful to know whether or not adult febrile patients have bacteremia.

Authors’ Affiliations

(1)
St Luke's International Hospital
(2)
St Luke's Life Science Institute

References

  1. Hoenig M, et al: Procalcitonin fails to predict bacteremia in SIRS patients: a cohort study. Int J Clin Pract. 2014, 68: 1278-81. 10.1111/ijcp.12474.View ArticleGoogle Scholar
  2. Hoeboer SH, et al: Old and new biomarkers for predicting high and low risk microbial infection in critically ill patients with new onset fever: a case for procalcitonin. J Infect. 2012, 64: 484-93. 10.1016/j.jinf.2012.01.002.View ArticlePubMedGoogle Scholar

Copyright

© Mikami et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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