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Follow-up blood cultures add little value in the management of bacteremic urinary tract infections

  • HyeJin Shi
  • Cheol-In KangEmail author
  • Sun Young Cho
  • Kyungmin Huh
  • Doo Ryeon Chung
  • Kyong Ran Peck
Original Article
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Abstract

The need for mandatory confirmation of negative conversion in bacteremic urinary tract infection (UTI) has not been adequately addressed, even though follow-up blood cultures (FUBCs) are still prescribed liberally. The purpose of this study was to identify possible risk factors associated with positive FUBCs. We retrospectively collected data on adult cases of bacteremic UTI with at least one FUBC. Patients were divided into the negative FUBCs and the positive FUBC group, and data of both groups were compared. Of 306 cases of bacteremic UTI, 251 had a negative result from an FUBC and 55 had a positive result. Diabetes mellitus, malignancy, complicated UTI, and initial intensive care unit (ICU) admission were significantly more common in the positive FUBC group than in the negative group (all-P < 0.05). Time to defervescence was significantly longer in the positive FUBC group than in the negative group (52.2 h vs. 25.3 h, P < 0.05). A multivariate analysis showed that malignancy, initial ICU admission, CRP > 16 (mg/dL), and a time to defervescence of more than 48 h were significant factors associated with a positive FUBC. No subsequent cases of bacteremia developed in patients without risk factors associated with a positive FUBC. In bacteremic UTIs, patients with positive FUBCs usually present with higher initial inflammatory markers, longer time to defervescence, more frequent ICU admission rates, and an elevated chance of having cancer. More careful clinical assessment before drawing FUBCs would reduce costs and inconvenience to patients.

Keywords

Urinary tract infection Bacteremia Follow-up blood culture Risk factor 

Notes

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10096_2019_3484_MOESM1_ESM.docx (41 kb)
ESM 1 (DOCX 41 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • HyeJin Shi
    • 1
    • 2
  • Cheol-In Kang
    • 1
    Email author
  • Sun Young Cho
    • 1
  • Kyungmin Huh
    • 1
  • Doo Ryeon Chung
    • 1
  • Kyong Ran Peck
    • 1
  1. 1.Division of Infectious Diseases, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Division of Infectious Diseases, Kangdong Sacred Heart HospitalHallym University School of MedicineSeoulRepublic of Korea

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