Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
Diagn Microbiol Infect Dis. 2011 May;70(1):31-6. doi: 10.1016/j.diagmicrobio.2010.12.007. Epub 2011 Mar 12.
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.
在接受中心静脉置管（CVC）的患者中，有血培养（BC）阳性而外周血培养（PBC）阴性的情况下，后续血流感染（BSI）的发生率以及全身抗生素的效果数据有限。我们回顾性分析了 1997 年 1 月至 2008 年 12 月间血液肿瘤科病房所有接受 Hickman 导管治疗的患者的配对血培养。共 112 例 CBC 阳性而 PBC 阴性的患者，其中 9 例（8.0%；95%CI，3.0-13.1%）在 28 天内发生了后续的 BSI。在经验性抗生素治疗不当的 31 例中有 6 例（19%）发生了后续的 BSI，而在经验性抗生素治疗恰当的 81 例中有 3 例（4%）发生了后续的 BSI（P=0.01）。后续念珠菌血症（50%，2/4）比后续菌血症（6%，108/1737）更为常见（P=0.03）。总之，在 CBC 阳性而 PBC 阴性的患者中，后续 BSI 的总体发生率为 8.0%，经验性抗生素治疗不当与后续 BSI 有关。
