JAMAevidence The Rational Clinical Examination
Does This Adult Patient With Suspected Bacteremia Require Blood Cultures? Interview With Dr Bryan Coburn
Sep 1, 2016
Dr. Bryan Coburn, a medical expert in bacteremia and blood cultures, joins the discussion to dissect when blood cultures are essential for hospitalized patients suspected of bacteremia. He emphasizes that only about 15% of blood cultures provide true positives and highlights clinical signs, such as shaking chills, as crucial indicators. The conversation also uncovers the risks of routine testing, false positives, and the importance of rapid diagnostic advancements, advocating for a thoughtful approach to testing based on clinical context.
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Quick takeaways
- Identifying the primary source of infection is crucial for assessing patients with suspected bacteremia and deciding on blood cultures.
- While blood cultures are essential for diagnosing certain infections, over-reliance can lead to false positives and extended hospital stays.
Deep dives
Understanding Bacteremia in Hospitalized Patients
Evaluating a patient with fever for potential bacteremia begins with identifying the primary source of infection. In hospitalized settings, bacteremia is often secondary to infections like pneumonia, catheter-associated bloodstream infections, and urinary tract infections. The likelihood of a true positive blood culture is about 15%, indicating that bacteremia is relatively rare but can be linked to common sources of infection in a medical environment. Therefore, a thorough assessment of these primary infection types is essential in guiding diagnosis and determining whether to order a blood culture.
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