https://scholars.lib.ntu.edu.tw/handle/123456789/561194
標題: | Correlation between time to positivity of blood cultures with clinical presentation and outcomes in patients with Klebsiella pneumoniae bacteraemia: Prospective cohort study | 作者: | Liao C.-H. Lai C.-C. Hsu M.-S. YU-TSUNG HUANG Chu F.-Y. Hsu H.-S. PO-REN HSUEH |
公開日期: | 2009 | 卷: | 15 | 期: | 12 | 起(迄)頁: | 1119-1125 | 來源出版物: | Clinical Microbiology and Infection | 摘要: | Time to positivity (TTP) of blood cultures in patients with bacteraemia is considered to be a predictor of outcome for some bacterial species. Two hundred and thirty-one patients with Klebsiella pneumoniae monomicrobial bacteraemia at a hospital from 1 January to 31 December 2007 were prospectively enrolled. TTP <7 h (46 patients, 19.9%) was associated with a higher Pittsburg bacteraemia score (6.2 ± 5.5 vs. 3.7 ± 4.3, p 0.002), fewer non-fatal diseases by the McCabe classification (39.1% vs. 64.9%, p 0.002), a higher percentage of patients with liver cirrhosis, active malignancy, and chemotherapy within 3 months (28.3% vs. 11.9%, p 0.007; 28.3% vs. 14.6%, p 0.031; 23.9% vs. 5.4%, p <0.001), more primary bacteraemia (45.7% vs. 22.2%, p 0.002), and a higher 30-day mortality rate (47.8% vs. 21.1%, p <0.001). Risk factors for 30-day mortality in the univariate analysis included higher Pittsburg bacteraemia score (5.8 ± 5.3 vs. 3.7 ± 4.3, p 0.002), primary bacteraemia (41.0% vs. 21.8%, p 0.004), TTP <7 h (36.1% vs. 14.1%, p <0.001), and the presence of active malignancy (29.5% vs. 12.9%, p 0.004). In the multivariate analysis, higher Pittsburg bacteraemia score (OR 1.07; 95% CI 1.01-1.14), TTP <7 h (OR 2.46; 95% CI 1.20-5.05) and active malignancy (OR 2.21; 95% CI 1.03-4.73) were the significant factors associated with 30-day mortality. In the Kaplan-Meier survival curve, short TTP was significantly associated with mortality at all time-points after admission. TTP of blood cultures, interpreted with a cut-off point of <7 h, in patients with K. pneumoniae bacteraemia can provide useful prognostic information. ? 2009 The Authors. Journal Compilation ? 2009 European Society of Clinical Microbiology and Infectious Diseases. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/561194 | ISSN: | 1198-743X | DOI: | 10.1111/j.1469-0691.2009.02720.x | SDG/關鍵字: | adult; article; bacteremia; bacterium isolate; blood culture; clinical article; cohort analysis; controlled study; correlation analysis; female; human; infection risk; Klebsiella pneumoniae; Klebsiella pneumoniae infection; liver cirrhosis; male; malignant neoplastic disease; mortality; priority journal; prognosis; Bacteria (microorganisms); Klebsiella pneumoniae |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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