Section for Infection Medicine, Department of Sciences Lund, Lund University, Lund, Sweden.
Clinical Microbiology, Labmedicin, Region Skåne, Lund, Sweden.
Eur J Clin Microbiol Infect Dis. 2021 Aug;40(8):1657-1664. doi: 10.1007/s10096-021-04210-9. Epub 2021 Mar 9.
Time to blood culture positivity (TTP) is an indirect measure of bacterial concentration in blood. A short TTP has been linked to the presence of infective endocarditis (IE) and to poor prognosis in Staphylococcus aureus bacteremia. We analyze factors influencing TTP in bacteremia with Enterococcus faecalis. This retrospective observational study of medical records included adults diagnosed with monomicrobial E. faecalis bacteremia between 2015 and 2018 in the Skåne region (Sweden). For each episode, the shortest TTP was recorded. Median TTP was compared between patients grouped based on age, sex, comorbidity, site of acquisition, and focus of infection. Using a dichotomized TTP (shorter or longer than 12 h), a multivariable logistic regression for factors associated to TTP was performed. The association between TTP and IE or mortality was evaluated. Three hundred sixty-seven episodes with monomicrobial E. faecalis bacteremia with the corresponding TTP were identified. Median TTP for the entire cohort was 11.6 (IQR 9.9-14.1) h and a significantly shorter TTP was noted for episodes which represented IE (n = 55, 9.4 (IQR 6.4-10.6) h). Only IE remained associated with a short TTP (≤ 12 h) in binary logistic regression analysis. Factors associated with IE were investigated and TTP was associated with IE also when adjusted for age, gender, comorbidity, and nosocomial acquisition. There was no association between TTP and mortality. A low TTP is associated with IE in E. faecalis bacteremia and could be used as a help in determining the need for echocardiography in patients with this condition.
血培养阳性时间（TTP）是血液中细菌浓度的间接衡量指标。TTP 较短与感染性心内膜炎（IE）的存在和金黄色葡萄球菌菌血症的不良预后有关。我们分析了屎肠球菌菌血症中影响 TTP 的因素。这是一项回顾性观察性研究，纳入了 2015 年至 2018 年在瑞典斯科讷地区诊断为单一致病菌血症的成年人。记录了每个病例的最短 TTP。根据年龄、性别、合并症、感染部位和感染灶，将患者分为不同组，比较各组的 TTP 中位数。使用 TTP 的二分法（更短或更长于 12 小时），对与 TTP 相关的因素进行多变量逻辑回归分析。评估 TTP 与 IE 或死亡率之间的关系。共确定了 367 例屎肠球菌单一致病菌血症的病例及其相应的 TTP，整个队列的 TTP 中位数为 11.6（IQR 9.9-14.1）小时，IE 组（n = 55）的 TTP 显著更短（9.4（IQR 6.4-10.6）小时）。在二元逻辑回归分析中，只有 IE 与 TTP 较短（≤12 小时）相关。进一步调查了与 IE 相关的因素，调整了年龄、性别、合并症和医院获得性感染后，TTP 与 IE 仍相关。TTP 与死亡率之间无相关性。在屎肠球菌菌血症中，TTP 较短与 IE 相关，这可能有助于确定患有这种疾病的患者是否需要进行超声心动图检查。
