title: Bacteraemia predictive factors among general medical inpatients: a retrospective cross-sectional survey in a Japanese university hospital.
abstract: The precise criteria for obtaining blood cultures have not been established; they depend on the physician's judgement. We examined clinical parameters to determine predictive factors of bacteraemia and the need for blood cultures among general medical inpatients.
  
  
  
  A retrospective cross-sectional survey.
  
  
  
  A Japanese university hospital.
  
  
  
  All general inpatients who had blood cultures taken from 1 January 2011 to 31 December 2012.
  
  
  
  Clinical information at or just before blood culture sampling was extracted from medical charts. Factors potentially predictive of bacteraemia were analysed using Fisher's exact test, followed by multivariable logistic regression model analysis.
  
  
  
  A total of 200 patients (male: female=119:81, 64.3±19.1 years old) comprised this study; 57 (28.5%) had positive blood culture results. Multivariable logistic regression analysis revealed that age >60 years (OR=2.75, 95% CI 1.23 to 6.48, p=0.015), female sex (OR=2.21, 95% CI 1.07 to 4.67, p=0.038), pulse rate >90 bpm (OR=5.18, 95% CI 2.25 to 12.48, p<0.001) and neutrophil percentage >80% (OR=3.61, 95% CI 1.71 to 8.00, p=0.001) were independent risk factors for positive blood culture results. The area under the receiver operating characteristic curve analysis of this model was 0.796.
  
  
  
  Our results emphasise the importance of taking blood cultures if the pulse rate is >90 bpm, in elderly patients and in women, and for ordering a differential white cell count.
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Sayato
authors.initials: S
authors.lastname: Fukui
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan Department of Infection Control Science, Faculty of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Uehara
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Fujibayashi
authors.affiliation: Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahashi
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Hisaoka
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan Department of Infection Control Science, Faculty of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Naito
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001170:Arthritis, Infectious / Q000453:epidemiology; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D000071997:Blood Culture / Q000706:statistics & numerical data; D001806:Blood Urea Nitrogen; D055499:Catheter-Related Infections / Q000453:epidemiology*; D062905:Central Venous Catheters; D002761:Cholangitis / Q000453:epidemiology*; D002764:Cholecystitis / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D015299:Discitis / Q000453:epidemiology; D004696:Endocarditis / Q000453:epidemiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006339:Heart Rate; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007958:Leukocyte Count; D008100:Liver Abscess / Q000453:epidemiology; D016015:Logistic Models; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000166:cytology; D011014:Pneumonia / Q000453:epidemiology; D011704:Pyelonephritis / Q000453:epidemiology*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D003404:Creatinine
keywords: GENERAL MEDICINE (see Internal Medicine); INFECTIOUS DISEASES