title: Utility of peripheral blood cultures in patients with cancer and suspected blood stream infections: a systematic review.
abstract: OBJECTIVE
  The utility of peripheral blood cultures in patients with cancer and/or hematopoietic stem cell transplantation (HSCT) recipients with central venous lines (CVL) and suspected blood stream infection (BSI) is controversial. Our main objective was to describe the proportion of bacteremia detected only by the peripheral blood (PB) culture in order to define its role in the evaluation of patients in this setting.
  
  
  METHODS
  We performed electronic searches of OVID Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for studies of adults or children with cancer and/or HSCT that evaluated concurrent PB and CVL cultures and reported sufficient data to permit calculation of the primary outcome. The proportion of bacteremia identified by site of sample was used as the effect measure. The review was registered in PROSPERO: CRD42011001610.
  
  
  RESULTS
  From 149 reviewed articles, 7 were included in the meta-analysis. In a total number of 10,370 paired blood cultures, bacteremia was detected in 17 %. Thirteen percent of BSI were only identified by PB, while 28 % of infections were only identified by CVL.
  
  
  CONCLUSIONS
  PB cultures identified many episodes of bacteremia not detected in the CVL culture. This finding suggests that PB culture should be considered in the evaluation of patients with cancer and/or HSCT with suspected BSI.
authors.affiliation: Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
authors.forename: Laura
authors.initials: L
authors.lastname: Rodríguez
authors.forename: Marie-Chantal
authors.initials: MC
authors.lastname: Ethier
authors.forename: Bob
authors.initials: B
authors.lastname: Phillips
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehrnbecher
authors.forename: John
authors.initials: J
authors.lastname: Doyle
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
mesh_terms: D016470:Bacteremia / Q000150:complications / Q000175:diagnosis*; D001769:Blood / Q000382:microbiology*; D001800:Blood Specimen Collection / Q000379:methods*; D002405:Catheterization, Central Venous; D002406:Catheterization, Peripheral; D062905:Central Venous Catheters; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D012680:Sensitivity and Specificity