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Validity of calendar day-based definitions for community-onset bloodstream infections.

Laupland KB, Gregson DB, Church DL - BMC Res Notes (2015)

Bottom Line: Thus the sensitivity and specificity of the 2-day definition was 98.6% and 100% and for the 3-day definition was 100% and 98.5%, respectively.Overall, only 311 (2.2%) cases were potentially miss-classifiable using either the 2- or 3-calendar day based definitions.Use of either a 2- or 3-day definition is highly accurate for classifying CO-BSI.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Royal Inland Hospital, 311 Columbia Street, Kamloops, BC, V2C 2T1, Canada. klaupland@gmail.com.

ABSTRACT

Background: Community-onset (CO) bloodstream infections (BSI) are those BSI where the blood culture is drawn <48 hours from hospital admission. However, exact times of culture draw or hospital admission are not always available. We evaluated the validity of using 2- or 3- calendar day based definitions for CO-BSI by comparing to a "gold standard" 48-hour definition.

Findings: Among the population-based cohort of 14,106 episodes of BSI studied, 10,543 were classified as CO based on "gold standard" 48-hour criteria. When 2-day and 3-day definitions were applied, 10,396 and 10,707 CO-BSI episodes were ascertained, respectively. All but 147 (1.4%) true CO-BSI cases were included by using the 2-day definition. When the 3-day definition was applied, all cases of CO-BSI were identified but and additional 164 (1.5%) cases of hospital-onset HO-BSI were also included. Thus the sensitivity and specificity of the 2-day definition was 98.6% and 100% and for the 3-day definition was 100% and 98.5%, respectively. Overall, only 311 (2.2%) cases were potentially miss-classifiable using either the 2- or 3-calendar day based definitions.

Conclusions: Use of either a 2- or 3-day definition is highly accurate for classifying CO-BSI.

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Related in: MedlinePlus

Timing of blood culture draw following admission to hospital for community-onset bloodstream infections.
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Fig1: Timing of blood culture draw following admission to hospital for community-onset bloodstream infections.

Mentions: Among the 8,730 true CO-BSI cases that were admitted to hospital, the median culture draw minus hospital admission time was −1 (IQR, −5 to 2) hours. The time of culture draw for these cases was distributed tightly around the time of admission as shown in Figure 1. Only 339 (3.9%) true CO-BSI cases were cultured between 24 and 47 hours following admission. In comparison, among the HO-BSI cases, the median time to culture draw was 12 (IQR, 6–24) days following admission. The distribution of these cases showed a progressive decrease from day 2. Of the HO-BSI cases, 290 (8%) were first cultured between 48–71 hours and 217 (6%) between 72 and 95 hours following hospital admission.Figure 1


Validity of calendar day-based definitions for community-onset bloodstream infections.

Laupland KB, Gregson DB, Church DL - BMC Res Notes (2015)

Timing of blood culture draw following admission to hospital for community-onset bloodstream infections.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389998&req=5

Fig1: Timing of blood culture draw following admission to hospital for community-onset bloodstream infections.
Mentions: Among the 8,730 true CO-BSI cases that were admitted to hospital, the median culture draw minus hospital admission time was −1 (IQR, −5 to 2) hours. The time of culture draw for these cases was distributed tightly around the time of admission as shown in Figure 1. Only 339 (3.9%) true CO-BSI cases were cultured between 24 and 47 hours following admission. In comparison, among the HO-BSI cases, the median time to culture draw was 12 (IQR, 6–24) days following admission. The distribution of these cases showed a progressive decrease from day 2. Of the HO-BSI cases, 290 (8%) were first cultured between 48–71 hours and 217 (6%) between 72 and 95 hours following hospital admission.Figure 1

Bottom Line: Thus the sensitivity and specificity of the 2-day definition was 98.6% and 100% and for the 3-day definition was 100% and 98.5%, respectively.Overall, only 311 (2.2%) cases were potentially miss-classifiable using either the 2- or 3-calendar day based definitions.Use of either a 2- or 3-day definition is highly accurate for classifying CO-BSI.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Royal Inland Hospital, 311 Columbia Street, Kamloops, BC, V2C 2T1, Canada. klaupland@gmail.com.

ABSTRACT

Background: Community-onset (CO) bloodstream infections (BSI) are those BSI where the blood culture is drawn <48 hours from hospital admission. However, exact times of culture draw or hospital admission are not always available. We evaluated the validity of using 2- or 3- calendar day based definitions for CO-BSI by comparing to a "gold standard" 48-hour definition.

Findings: Among the population-based cohort of 14,106 episodes of BSI studied, 10,543 were classified as CO based on "gold standard" 48-hour criteria. When 2-day and 3-day definitions were applied, 10,396 and 10,707 CO-BSI episodes were ascertained, respectively. All but 147 (1.4%) true CO-BSI cases were included by using the 2-day definition. When the 3-day definition was applied, all cases of CO-BSI were identified but and additional 164 (1.5%) cases of hospital-onset HO-BSI were also included. Thus the sensitivity and specificity of the 2-day definition was 98.6% and 100% and for the 3-day definition was 100% and 98.5%, respectively. Overall, only 311 (2.2%) cases were potentially miss-classifiable using either the 2- or 3-calendar day based definitions.

Conclusions: Use of either a 2- or 3-day definition is highly accurate for classifying CO-BSI.

Show MeSH
Related in: MedlinePlus