Development of subsequent bloodstream infection in patients with positive Hickman catheter blood cultures and negative peripheral blood cultures |
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Authors: | Park Ki-Ho Cho Oh-Hyun Lee Sang-Oh Choi Sang-Ho Kim Yang Soo Woo Jun Hee Kim Mi-Na Kim Dae-Young Lee Jung-Hee Lee Je-Hwan Lee Kyoo-Hyung Lee Dae Ho Suh Cheolwon Kim Sung-Han |
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Institution: | Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea. |
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Abstract: | There are limited data on the incidence of subsequent bloodstream infection (BSI) and the effect of systemic antibiotics in patients who had positive catheter-drawn blood cultures (CBC) and negative peripheral blood cultures (PBC). We retrospectively reviewed all paired blood cultures from patients with Hickman catheter in the hematology-oncology ward between January 1997 and December 2008. There were 112 episodes with positive CBC and negative PBC. Nine episodes (8.0%; 95% CI, 3.0-13.1%) led to subsequent BSI within 28 days. Subsequent BSI developed in 6 of 31 episodes (19%) where empiric antibiotics were inappropriate but in 3 of 81 episodes (4%) where empiric antibiotics were appropriate (P = 0.01). Subsequent candidemia (50%, 2 of 4) was more common than subsequent bacteremia (6%, 7 of 108) (P = 0.03). In conclusion, for patients with positive CBC and negative PBC, the overall incidence of subsequent BSI was 8.0%, and inappropriate empiric antibiotics was associated with subsequent BSI. |
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Keywords: | Blood cultures Bloodstream infection Cancer Hickman catheter Central venous catheter |
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