title: Predicting bacteremia based on nurse-assessed food consumption at the time of blood culture.
abstract: BACKGROUND
  Bacteremia and its complications are important causes of morbidity and mortality in hospitalized patients. However, the yield of blood cultures is relatively low, with many false-positive results from bacterial contamination.
  
  
  METHODS
  We investigated the relationship between patient food consumption and the presence of bacteremia. This was an observational analysis of a cohort of 1179 patients who underwent blood culture analysis between January 2005 and December 2009. Patients with anorexia-inducing conditions, such as gastrointestinal illness and malignant disease treated with chemotherapy, were excluded. Food consumption was rated by nurses as the percentage of food consumed during the meal preceding the blood culture. Groupings were as follows: low consumption (<50%), moderate (>50% to <80%), and high (>80%).
  
  
  RESULTS
  Low consumption was observed in 39.8% of patients, moderate in 17.8%, and high in 41.6%. The average body temperature was 38.1 ± 1.1°C. Bacteremia was present in 18.5%, 3.9%, and 1.4% of patients in the low, moderate, and high food consumption groups, respectively. The negative predictive value was 98.3%, suggesting that bacteremia is very unlikely in the setting of good food intake.
  
  
  CONCLUSIONS
  Bacteremia is an unlikely occurrence in hospitalized patients who maintain adequate food consumption at the time of blood culture.
authors.affiliation: Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Komatsu
authors.forename: Toshihito
authors.initials: T
authors.lastname: Onda
authors.forename: Go
authors.initials: G
authors.lastname: Murayama
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamanouchi
authors.forename: Minori
authors.initials: M
authors.lastname: Inukai
authors.forename: Ai
authors.initials: A
authors.lastname: Sakai
authors.forename: Masumi
authors.initials: M
authors.lastname: Kikuta
authors.forename: Joel
authors.initials: J
authors.lastname: Branch
authors.forename: Makoto
authors.initials: M
authors.lastname: Aoki
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Tierney
authors.forename: Kenji
authors.initials: K
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000453:epidemiology; D001431:Bacteriological Techniques; D001769:Blood / Q000382:microbiology*; D001831:Body Temperature; D015331:Cohort Studies; D005260:Female; D005502:Food / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests