Chest
Clinical Investigations: Infection: ArticlesClinical Utility of Blood Cultures in Adult Patients with Community-Acquired Pneumonia Without Defined Underlying Risks
Section snippets
Patient Population
Study patients were identified from a listing of 1,250 adults (≥18 years old) with hospital discharge diagnosis of pneumonia during 1991 at Grady Memorial Hospital, a large inner-city hospital in Atlanta. Patients with HIV infection, hematologic malignancies, metastatic solid neoplasm receiving chemotherapy, sickle cell disease, or steroid therapy were excluded. Patients were also excluded if they resided in nursing homes or had been discharged from a hospital less than 14 days prior to
Results
Of the 1,250 patients with hospital discharge diagnosis of pneumonia, 517 patients met study criteria. Ages of study patients ranged from 18 to 103 years with mode of 33 years (18 of the study patients) and mean of 51.7 years (SD±18.9). The mean age of the culture-positive patients was 43.2 years, while the mean age of the culture-negative patients was 51.8 years (p=0.007). Duration of hospital stay ranged from 0 to 31 days. Mean stay of patients with true positive cultures was 6.9 days while
Discussion
In our retrospective study of patients admitted to the hospital for CAP, blood cultures were infrequently positive in adult patients without the defined underlying risk factors. The patients we studied were directly admitted to the hospital on presentation for CAP. Of these patients, we excluded those with immunocompromised states such as HIV, hematologic and solid malignancies, sickle cell disease, steroid dependence, or nursing home residence. Fine et al20 found an increased risk of a
ACKNOWLEDGMENTS
The authors thank the developers of the Grady THERESA system for use of the database, Steve Brown, MD, for accessing the population set, Erika Elvander, MPH, for statistical assistance, and Eric Honig, MD, and David Stephens, MD, for reviewing the article before publication.
References (32)
- et al.
Hospital study of adult community-acquired pneumonia
Lancet
(1982) - et al.
Pneumococcal pneumonia with bacteremia
Br J Dis Chest
(1984) Community-acquired pneumonia
Br J Dis Chest
(1987)- et al.
Hospitalization decision in patients with community-acquired pneumonia: a prospective cohort study
Am J Med
(1990) - et al.
Community-acquired pneumonia: importance of initial noninvasive bacteriologic and radiologic investigations
Chest
(1988) - et al.
Prospective study of the etiology and outcome of pneumonia in the community
Lancet
(1987) - et al.
Etiology of community-acquired pneumonia: evaluation by transtracheal aspiration, blood culture, or serology
Chest
(1993) - et al.
New and emerging etiologies for community-acquired pneumonia with implications for therapy
Medicine
(1990) - et al.
Community-acquired pneumonia requiring hospitalization: 5-year prospective study
Rev Infect Dis
(1989) - Research Committee of the British Thoracic Society and the Public Health Laboratory Service. Community acquired...
Prognosis in community-acquired pneumonia requiring treatment in hospital: importance of predisposing and complicating factors, and of diagnostic procedures
Scand J Infect Dis Suppl
A hospital study of community-acquired pneumonia in the elderly
Thorax
Community-acquired pneumonia
Clin Infect Dis
Pneumococcal bacteremia: 325 episodes at St
Thomas Hospital. BMJ
Failure of intensive care unit support to influence mortality from pneumococcal bacteremia
JAMA
Comparison of community-acquired and nosocomial pneumococcal bacteremia
Am Rev Respir Dis
Cited by (0)
Read before the 59th Annual International Convention of the American College of Chest Physicians, Orlando, Fla, October 1993 (winner of the Dupont Young Investigator Award).