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Accuracy of procalcitonin for diagnosing peripheral blood culture contamination among patients with positive blood culture for potential contaminants

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Abstract

Purpose

Blood culture contamination is still a frequently observed event and may lead to unnecessary antibiotic prescriptions and additional hazards and costs. However, in patients hospitalized in tertiary care, true bacteremias for pathogens that are classically considered as contaminants can be observed. We assessed the diagnostic accuracy of procalcitonin for differentiating blood culture contamination from bacteremia in patients with positive blood cultures for potential contaminants.

Methods

We carried out a retrospective, cross-sectional, observational study on consecutive patients hospitalized between January 2016 and May 2019 at the University Hospital of Nancy and who had a positive peripheral blood culture for a pathogen classically considered as a potential contaminant.

Results

During the study period, 156 patients were screened, and 154 were retained in the analysis. Among the variables that were significantly associated with a diagnosis of blood culture contamination in univariate analyses, four were maintained in multivariate logistic regression analysis: a number of positive blood culture bottles ≤ 2 (OR 23.76; 95% CI 1.94–291.12; P = 0.01), procalcitonin < 0.1 ng/mL (OR 14.88; 95% CI 1.62–136.47; P = 0.02), non-infection-related admission (OR 13.00; 95% CI 2.17–77.73; P = 0.005), and a percentage of positive blood culture bottles ≤ 25% (OR 12.15; 95% CI 2.02–73.15; P = 0.006).

Conclusions

These data provide new evidence on the usefulness of plasma procalcitonin as a reliable diagnostic biomarker in the diagnostic algorithm of peripheral blood culture contamination among patients hospitalized in tertiary care.

Clinical trial

ClinicalTrials.gov #NCT04573894.

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Data availability

Anonymized patient data are available for use in collaborative studies to researchers upon reasonable request (a.lozniewski@chru-nancy.fr and abderrahim.oussalah@univ-lorraine.fr). Data will be provided following the review and approval of a research proposal (including a statistical analysis plan) and the completion of a data-sharing agreement. Responses to the request for the raw data will be judged by the IRB of the University Hospital of Nancy.

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Acknowledgements

We wish to thank all the patients and staff from all the units that participated in the study.

Funding

University Hospital of Nancy, Department of Methodology, Promotion, and Investigation.

Author information

Authors and Affiliations

  1. Department of Microbiology, University Hospital of Nancy, F-54000, Vandoeuvre-lès-Nancy, France

    Clémence Berthezène, Nejla Aissa, Anne Elisabeth Manteaux & Alain Lozniewski

  2. Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000, Vandoeuvre-lès-Nancy, France

    Jean-Louis Guéant & Abderrahim Oussalah

  3. INSERM UMR_S 1256 Nutrition, Genetics, and Environmental Risk Exposure (NGERE), University of Lorraine, Faculty of Medicine of Nancy, 9 Avenue de la Forêt de Haye, F-54000, Vandoeuvre-lès-Nancy, Nancy, France

    Jean-Louis Guéant & Abderrahim Oussalah

  4. EA7300, Stress Immunity Pathogens Laboratory, Faculty of Medicine of Nancy, University of Lorraine, F-54000, Vandoeuvre-lès-Nancy, France

    Alain Lozniewski

Authors
  1. Clémence Berthezène
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  2. Nejla Aissa
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  3. Anne Elisabeth Manteaux
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  4. Jean-Louis Guéant
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  5. Abderrahim Oussalah
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  6. Alain Lozniewski
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Contributions

Study concept and design: AL and AO; study supervision, guarantors of the article: AL and AO; data collection: CB; statistical analysis: AO; acquisition of data: CB; drafting, review, and approval of the report: CB, NA, AEM, JLG, AO, and AL; critical revision of the manuscript for important intellectual content: CB, NA, AEM, JLG, AO, and AL; approved the final draft submitted: CB, NA, AEM, JLG, AO, and AL.

Corresponding authors

Correspondence to Abderrahim Oussalah or Alain Lozniewski.

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Conflict of interest

The authors who have taken part in this study declare that they do not have anything to disclose regarding conflicts of interest concerning this manuscript.

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Berthezène, C., Aissa, N., Manteaux, A.E. et al. Accuracy of procalcitonin for diagnosing peripheral blood culture contamination among patients with positive blood culture for potential contaminants. Infection 49, 1249–1255 (2021). https://doi.org/10.1007/s15010-021-01697-4

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  • DOI: https://doi.org/10.1007/s15010-021-01697-4

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