title: Relevance of blood cultures in acute pyelonephritis in a single-center retrospective study.
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.
authors: 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.
authors: Stanislas
authors: S
authors: Ledochowski
authors: Paul-Samuel
authors: PS
authors: Abraham
authors: Xavier
authors: X
authors: Jacob
authors: Oana
authors: O
authors: Dumitrescu
authors: Gérard
authors: G
authors: Lina
authors: Alain
authors: A
authors: Lepape
authors: Vincent
authors: V
authors: Piriou
authors: Florent
authors: F
authors: Wallet
authors: Arnaud
authors: A
authors: Friggeri
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology*; D000071997:Blood Culture; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000097:blood / Q000382:microbiology* / Q000652:urine; D012189:Retrospective Studies; D055815:Young Adult