Session Type: ePosters
Session Title: ePosters
Authors(s): R. Fernández Guerrero (1, 2), J.A. Girón Ortega (1, 2), E. Morte Romea (3), P. Luque Gómez (3), C. Sánchez Tembleque (4), M. Montes De Oca (4), M. López De Cueto (1, 2), L.R. Suardi (5), Z.R. Palacios Baena (1, 2), S. Jiménez Jorge (6), J. Rodríguez Baño (1, 2), P. Retamar Gentil (1, 2)
Authors Affiliations(s): (1) University Hospital Virgen Macarena, Spain, (2) Institute of Biomedicine of Seville ( IBiS ), Spain, (3) University Hospital Lozano Blesa, Spain, (4) University Hospital Puerta del Mar, Spain, (5) Department of clinical and experimental medicine, University of Florenceniversity Hospital Virgen Macarena, Italy, (6) Clinical trials unit, University Hospital Virgen del Rocio, Spain
Background:
There are scarce data about patients with negative blood culture (NBC) despite the fact they represent more than 80% of all the patients from whom blood cultures are taken during hospital admissions. The aim of this study was to analyze the clinical, therapeutic and prognostic characteristics in patients with NBC.
Methods:NO-BACT project was a multicenter, prospective cohort study conducted in three academic spanish hospitals with remarkable experience in antimicrobial stewardship (ASP) programs, from October 2018 to July 2019. The features of randomly selected patients with BC were collected on day 0 (day of blood culture extraction), day 2 and day 5. Adequacy of antibiotic treatment on days 2 and 5 was evaluated according to local guidelines.
Results:
The results are summarised in Figure 1 and Figure 2; 803 patients were included; 40% had a community-acquired episode. 193 patients had remarkable previous comorbidities (Charlson score ≥3). The main focus of suspected infection were pneumonia (n=260, 32%) and urinary tract (N=146, 18%). A quickSOFA score =2 was seen in 73 patients at day 0 (9%), 24 at day 2 (3%) and 10 at day 5 (<1%). The median value of CRP was 66 mg/dl at day 0, 91 at day 2 and 38 at day 5. Ceftriaxone was the most common empirical antibiotic on days 0 (17%) and 2 (16%), although piperacillin/tazobactam was the most common at day 5 (11%). Antibiotic treatment at day 2 was considered inadequate in 299 (40%) of the cases, due to insufficient coverage in 130 (21%) and too broad coverage in 111 (18%), respectively. At day 5, antibiotic treatment was considered inadequate in 266 (46%) of the cases, due to insufficient coverage in 67 (15%) and too broad coverage in 104 ( 24%) of the cases respectively. Overall mortality at 30 days was 9%.
Conclusions:Patients with NBC often received inadequate antimicrobial treatment, which may have clinical relevance, and suggest that this population may be a convenient and novel target for antimicrobial stewardship activities.
Keyword(s): Negative blood cultures, Adequacy treatment, Antimicrobial stewardshipSession Type: ePosters
Session Title: ePosters
Authors(s): R. Fernández Guerrero (1, 2), J.A. Girón Ortega (1, 2), E. Morte Romea (3), P. Luque Gómez (3), C. Sánchez Tembleque (4), M. Montes De Oca (4), M. López De Cueto (1, 2), L.R. Suardi (5), Z.R. Palacios Baena (1, 2), S. Jiménez Jorge (6), J. Rodríguez Baño (1, 2), P. Retamar Gentil (1, 2)
Authors Affiliations(s): (1) University Hospital Virgen Macarena, Spain, (2) Institute of Biomedicine of Seville ( IBiS ), Spain, (3) University Hospital Lozano Blesa, Spain, (4) University Hospital Puerta del Mar, Spain, (5) Department of clinical and experimental medicine, University of Florenceniversity Hospital Virgen Macarena, Italy, (6) Clinical trials unit, University Hospital Virgen del Rocio, Spain
Background:
There are scarce data about patients with negative blood culture (NBC) despite the fact they represent more than 80% of all the patients from whom blood cultures are taken during hospital admissions. The aim of this study was to analyze the clinical, therapeutic and prognostic characteristics in patients with NBC.
Methods:NO-BACT project was a multicenter, prospective cohort study conducted in three academic spanish hospitals with remarkable experience in antimicrobial stewardship (ASP) programs, from October 2018 to July 2019. The features of randomly selected patients with BC were collected on day 0 (day of blood culture extraction), day 2 and day 5. Adequacy of antibiotic treatment on days 2 and 5 was evaluated according to local guidelines.
Results:
The results are summarised in Figure 1 and Figure 2; 803 patients were included; 40% had a community-acquired episode. 193 patients had remarkable previous comorbidities (Charlson score ≥3). The main focus of suspected infection were pneumonia (n=260, 32%) and urinary tract (N=146, 18%). A quickSOFA score =2 was seen in 73 patients at day 0 (9%), 24 at day 2 (3%) and 10 at day 5 (<1%). The median value of CRP was 66 mg/dl at day 0, 91 at day 2 and 38 at day 5. Ceftriaxone was the most common empirical antibiotic on days 0 (17%) and 2 (16%), although piperacillin/tazobactam was the most common at day 5 (11%). Antibiotic treatment at day 2 was considered inadequate in 299 (40%) of the cases, due to insufficient coverage in 130 (21%) and too broad coverage in 111 (18%), respectively. At day 5, antibiotic treatment was considered inadequate in 266 (46%) of the cases, due to insufficient coverage in 67 (15%) and too broad coverage in 104 ( 24%) of the cases respectively. Overall mortality at 30 days was 9%.
Conclusions:Patients with NBC often received inadequate antimicrobial treatment, which may have clinical relevance, and suggest that this population may be a convenient and novel target for antimicrobial stewardship activities.
Keyword(s): Negative blood cultures, Adequacy treatment, Antimicrobial stewardship