Department of Laboratory Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.
Department of Hospital Infection Control, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.
Epidemiol Infect. 2023 Feb 21;151:e43. doi: 10.1017/S0950268823000262.
The association between time to positivity (TTP) of blood culture and the clinical prognosis of patients with bloodstream infection (BSI) remains unclear. A retrospective study of 148 inpatients with BSI caused by was performed at Shanghai Tongji Hospital, China, from October 2016-2020. The total in-hospital fatality rate was 32%. The median TTP was 11.0 (7.7-16.1) h and the optimal cutoff for prediction of in-hospital mortality was 9.4 h according to the ROC curve. Early TTP (<9.4 h) was a risk factor for in-hospital mortality by univariate analysis (OR = 2.5, 95% CI 1.2-5.0, = 0.01), but not by multivariate analysis (OR = 2.7, 95% CI 1.0-7.4, = 0.06). Old age, serum creatinine, white blood cells, and C-reactive protein values were risk factors for in-hospital mortality by multivariate analysis. Early TTP was not a risk factor for septic shock (OR = 1.8, 95% CI 0.6-5.1, = 0.27) or ICU admission (OR = 1.0, 95% CI 1.0-1.0, = 0.32). In conclusion, the in-hospital fatality rate of patients with BSI was relatively high and associated with an early TTP of blood cultures. However, no increased risk of mortality, septic shock or ICU admission was evident in early TTP patients.
血培养阳性时间（TTP）与血流感染（BSI）患者临床预后的关系尚不清楚。本研究回顾性分析了 2016 年 10 月至 2020 年期间上海同济大学附属同济医院 148 例由 引起的 BSI 住院患者。总的院内病死率为 32%。中位 TTP 为 11.0（7.7-16.1）h，ROC 曲线下面积显示预测院内死亡的最佳截断值为 9.4 h。单因素分析显示，早期 TTP（<9.4 h）是院内死亡的危险因素（OR=2.5，95%CI 1.2-5.0， = 0.01），但多因素分析无统计学意义（OR=2.7，95%CI 1.0-7.4， = 0.06）。多因素分析显示，高龄、血清肌酐、白细胞和 C 反应蛋白是院内死亡的危险因素。早期 TTP 不是发生感染性休克（OR=1.8，95%CI 0.6-5.1， = 0.27）或入住 ICU（OR=1.0，95%CI 1.0-1.0， = 0.32）的危险因素。总之，BSI 患者的院内病死率较高，与血培养早期 TTP 相关。然而，早期 TTP 患者的死亡率、感染性休克或 ICU 入住率并无显著增加。
