Singh Harjinder, Sheth Radhika, Bhatia Mehakmeet, Muhammad Abdullah, Bachour Candi, Metcalf David, Kak Vivek
Internal Medicine Henry Ford Allegiance Health, Jackson, MI, USA.
Research and sponsored programs Henry Ford Allegiance Health, Jackson, MI, USA.
Spartan Med Res J. 2024 Sep 10;9(3):123414. doi: 10.51894/001c.123414. eCollection 2024.
This study was performed to identify patient factors associated with hospital-acquired bloodstream infections (HABSI) to guide blood culture collection and empiric antibiotic therapy.
A retrospective case-control study reviewed the medical records of 350 patients admitted to our health system from September 2017 to April 2020. The patients were 18 years and older and had at least one set of new positive non-contaminant blood cultures collected after 48 hours of admission, defined as HABSI. We developed clinical variables through a literature review associated with it. Univariate relationships between each variable and bacteremia were evaluated by chi-square test. A predictive model was developed through stepwise multivariate logistic regression.
The univariate analysis and stepwise regression analysis showed that temperature >100.4° F (OR: 1.9, CI 1.1 to 3.4), male sex (OR: 1.8, CI 1.0 to 3.0), and platelet count <150,000/µL (OR: 1.8, CI 1.0 to 3.2) were statistically associated with a positive blood culture.
This model helps identify patients with clinical characteristics associated with the likelihood of HABSI. This model can help guide the appropriate initiation of empiric antibiotics in clinical situations and assist with antibiotic stewardship.
本研究旨在确定与医院获得性血流感染（HABSI）相关的患者因素，以指导血培养采集和经验性抗生素治疗。
一项回顾性病例对照研究回顾了2017年9月至2020年4月期间入住我们医疗系统的350例患者的病历。患者年龄在18岁及以上，入院48小时后至少采集了一组新的阳性非污染血培养物，定义为HABSI。我们通过文献综述确定了与之相关的临床变量。通过卡方检验评估每个变量与菌血症之间的单变量关系。通过逐步多因素逻辑回归建立预测模型。
单变量分析和逐步回归分析表明，体温>100.4°F（比值比：1.9，可信区间1.1至3.4）、男性（比值比：1.8，可信区间1.0至3.0）和血小板计数<150,000/µL（比值比：1.8，可信区间1.0至3.2）与血培养阳性在统计学上相关。
该模型有助于识别具有与HABSI可能性相关临床特征的患者。该模型可帮助指导临床情况下经验性抗生素的适当启用，并有助于抗生素管理。
