PDF(Pubmed)
Abstract：
UNASSIGNED: We aimed to aid the appropriate use of antimicrobial agents by determining the timing of secondary bacteremia and validating and updating clinical prediction models for bacteremia in patients with COVID-19.
UNASSIGNED: We performed a retrospective cohort study on all hospitalized patients diagnosed with COVID-19 who underwent blood culture tests from January 1, 2020, and September 30, 2021, at an urban teaching hospital in Japan. The primary outcome measure was secondary bacteremia in patients with COVID-19.
UNASSIGNED: Of the 507 patients hospitalized with COVID-19, 169 underwent blood culture tests. Eleven of them had secondary bacteremia. The majority of secondary bacteremia occurred on or later than the 9th day after symptom onset. Positive blood culture samples collected on day 9 or later after disease onset had an odds ratio of 22.4 (95% CI 2.76-181.2, p < 0.001) compared with those collected less than 9 days after onset. The area under the receiver operating characteristic curve of the modified Shapiro rule combined with blood culture collection on or after the 9th day from onset was 0.919 (95% CI, 0.843-0.995), and the net benefit was high according to the decision curve analysis.
UNASSIGNED: The timings of symptom onset and hospital admission may be valuable indicators for making a clinical decision to perform blood cultures in patients hospitalized with COVID-19.
UNASSIGNED: We performed a retrospective cohort study on all hospitalized patients diagnosed with COVID-19 who underwent blood culture tests from January 1, 2020, and September 30, 2021, at an urban teaching hospital in Japan. The primary outcome measure was secondary bacteremia in patients with COVID-19.
UNASSIGNED: Of the 507 patients hospitalized with COVID-19, 169 underwent blood culture tests. Eleven of them had secondary bacteremia. The majority of secondary bacteremia occurred on or later than the 9th day after symptom onset. Positive blood culture samples collected on day 9 or later after disease onset had an odds ratio of 22.4 (95% CI 2.76-181.2, p < 0.001) compared with those collected less than 9 days after onset. The area under the receiver operating characteristic curve of the modified Shapiro rule combined with blood culture collection on or after the 9th day from onset was 0.919 (95% CI, 0.843-0.995), and the net benefit was high according to the decision curve analysis.
UNASSIGNED: The timings of symptom onset and hospital admission may be valuable indicators for making a clinical decision to perform blood cultures in patients hospitalized with COVID-19.
摘要：
■我们的目标是通过确定继发性菌血症的时机以及验证和更新COVID-19患者菌血症的临床预测模型来帮助适当使用抗菌药物。
我们对2020年1月1日和2021年9月30日在日本城市教学医院接受血液培养测试的所有确诊为COVID-19的住院患者进行了回顾性队列研究。主要结局指标是COVID-19患者的继发性菌血症。
■在507例COVID-19住院患者中，有169例接受了血培养检查。其中11人患有继发性菌血症。大多数继发性菌血症发生在症状发作后第9天或更晚。在发病后第9天或更晚收集的阳性血培养样本与发病后不到9天收集的样本相比，比值比为22.4（95％CI2.76-181.2，p<0.001）。在发病第9天或之后，改良的Shapiro规则结合血培养收集的受试者工作特征曲线下面积为0.919（95％CI，0.843-0.995），根据决策曲线分析，净收益较高。
症状发作和入院时间可能是临床决定对COVID-19住院患者进行血培养的有价值的指标。
我们对2020年1月1日和2021年9月30日在日本城市教学医院接受血液培养测试的所有确诊为COVID-19的住院患者进行了回顾性队列研究。主要结局指标是COVID-19患者的继发性菌血症。
■在507例COVID-19住院患者中，有169例接受了血培养检查。其中11人患有继发性菌血症。大多数继发性菌血症发生在症状发作后第9天或更晚。在发病后第9天或更晚收集的阳性血培养样本与发病后不到9天收集的样本相比，比值比为22.4（95％CI2.76-181.2，p<0.001）。在发病第9天或之后，改良的Shapiro规则结合血培养收集的受试者工作特征曲线下面积为0.919（95％CI，0.843-0.995），根据决策曲线分析，净收益较高。
症状发作和入院时间可能是临床决定对COVID-19住院患者进行血培养的有价值的指标。
