Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Virulence. 2024 Dec;15(1):2329397. doi: 10.1080/21505594.2024.2329397. Epub 2024 Mar 28.
is a common causative pathogen of intra-abdominal infection with concomitant bacteraemia, leading to a significant mortality risk. The time to positivity (TTP) of blood culture is postulated to be a prognostic factor in bacteraemia caused by other species. Therefore, this study aimed to investigate the prognostic value of TTP in these patients. The single-centred, retrospective, observational cohort study was conducted between 1 July 2016 and 30 June 2021. All adult emergency department patients with diagnosis of intra-abdominal infection and underwent blood culture collection which yield during this period were enrolled. A total of 196 patients were included in the study. The overall 30-day mortality rate was 12.2% (24/196), and the median TTP of the studied cohort was 12.3 h (10.5-15.8 h). TTP revealed a moderate 30-day mortality discriminative ability (area under the curve 0.73, < 0.001). Compared with the late TTP group (>12 h, = 109), patients in the early TTP (≤12 h, = 87) group had a significantly higher risk of 30-day morality (21.8% vs. 4.6%, < 0.01) and other adverse outcomes. Furthermore, TTP (odds ratio [OR] = 0.79, = 0.02), Pitt bacteraemia score (OR = 1.30, = 0.03), and implementation of source control (OR = 0.06, < 0.01) were identified as independent factors related to 30-day mortality risk in patients with intra-abdominal infection and bacteraemia. Therefore, physicians can use TTP for prognosis stratification in these patients.
是导致腹腔内感染合并菌血症的常见病原体，显著增加病死率。血培养阳性时间（TTP）被认为是其他病原体引起菌血症的预后因素。因此，本研究旨在探讨 TTP 对这些患者的预后价值。这是一项单中心、回顾性、观察性队列研究，于 2016 年 7 月 1 日至 2021 年 6 月 30 日进行。纳入在此期间诊断为腹腔内感染并接受血培养采集的所有成年急诊患者。共纳入 196 例患者。总的 30 天病死率为 12.2%（24/196），研究队列的中位 TTP 为 12.3 小时（10.5-15.8 小时）。TTP 对 30 天病死率具有中等的判别能力（曲线下面积 0.73， < 0.001）。与晚期 TTP 组（>12 小时， = 109）相比，早期 TTP 组（≤12 小时， = 87）患者 30 天病死率明显更高（21.8% vs. 4.6%， < 0.01）和其他不良结局。此外，TTP（比值比 [OR] = 0.79， = 0.02）、Pitt 菌血症评分（OR = 1.30， = 0.03）和实施源头控制（OR = 0.06， < 0.01）被确定为腹腔内感染和菌血症患者 30 天病死率的独立相关因素。因此，医生可以使用 TTP 对这些患者进行预后分层。
