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Relevance of blood cultures in acute pyelonephritis in a single-center retrospective study

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Abstract

Pyelonephritides are frequently encountered diagnosis in Emergency Departments. Urinalyses have a central place in the management of this situation but the usefulness of blood cultures is not clear. We conducted a single-center retrospective study of 24 months to study the microbiological relevance of blood cultures in pyelonephritis. We included patients with blood cultures (BC) and urine cultures (UC) drawn at the same time, if they were not exposed to antibiotics prior to these tests. Of our 264 patients, 39 (15 %) had no bacteriological documentation. There were 83 (31 %) bacteremic patients. Seven patients had contaminated or sterile UC with positive BC. Four patients had positive UC and BC with the latter allowing identification of a pathogen absent from the UC (n = 1) or identifying the main pathogen in three cases. A total of 11 patients theoretically benefited from BC representing 4.2 % of our population. Excluding one patient who was known to be infected with multi-drug resistant bacteria, all empirical antibiotics regimens were effective against the identified pathogens. We did not reveal any significant therapeutic impact of blood cultures in the management of pyelonephritis, when BC and UC are performed before any antimicrobials treatment.

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Acknowledgments

There are no acknowledgements. No organizations funded this research and no Grants were allocated.

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Statement of human and animal rights

This article does not contain any additional procedures performed on patients by any of the authors, being an observational retrospective study.

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No informed consent was recquired because of the nature of this study.

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Authors and Affiliations

  1. Service d’Anesthésie-Réanimation Médicale et Chirurgicale, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69395, Lyon, Pierre-Bénite, France

    Stanislas Ledochowski, Paul-Samuel Abraham, Alain Lepape, Vincent Piriou, Florent Wallet & Arnaud Friggeri

  2. Service d’Accueil des Urgences, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, Lyon, Pierre-Bénite, France

    Xavier Jacob

  3. Laboratoire de Microbiologie, Centre de Biologie Sud, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, Lyon, Pierre-Bénite, France

    Oana Dumitrescu & Gérard Lina

  4. Université Claude Bernard Lyon 1, 69007, Lyon, France

    Oana Dumitrescu, Gérard Lina, Alain Lepape, Vincent Piriou, Florent Wallet & Arnaud Friggeri

  5. Inserm U1111 CIRI, Université Claude Bernard Lyon I, 69007, Lyon, France

    Oana Dumitrescu & Gérard Lina

Authors
  1. Stanislas Ledochowski
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  2. Paul-Samuel Abraham
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  3. Xavier Jacob
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  4. Oana Dumitrescu
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  5. Gérard Lina
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  6. Alain Lepape
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  7. Vincent Piriou
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  8. Florent Wallet
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  9. Arnaud Friggeri
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Corresponding author

Correspondence to Arnaud Friggeri.

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Ledochowski, S., Abraham, PS., Jacob, X. et al. Relevance of blood cultures in acute pyelonephritis in a single-center retrospective study. Intern Emerg Med 10, 607–612 (2015). https://doi.org/10.1007/s11739-015-1223-7

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  • DOI: https://doi.org/10.1007/s11739-015-1223-7

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