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dc.contributor.authorGreen, Alexis L.
dc.contributor.authorLiang, Yuanyuan
dc.contributor.authorO'Hara, Lyndsay M.
dc.contributor.authorPineles, Lisa
dc.contributor.authorSorongon, Scott
dc.contributor.authorHarris, Anthony D.
dc.contributor.authorBaghdadi, Jonathan D.
dc.date.accessioned2022-05-23T11:22:27Z
dc.date.available2022-05-23T11:22:27Z
dc.date.issued2021-08-27
dc.identifier.urihttp://hdl.handle.net/10713/18963
dc.description.abstractObjectives: Evidence supporting collection of follow-up blood cultures for Gram-negative bacteremia is mixed. We sought to understand why providers order follow-up blood cultures when managing P. aeruginosa bacteremia and whether follow-up blood cultures in this context are associated with short- and long-term survival. Methods: We conducted a retrospective cohort study of adult inpatients with P. aeruginosa bacteremia at the University of Maryland Medical Center in 2015-2020. Kaplan-Meier survival curves and Cox regression with time-varying covariates were used to evaluate the association between follow-up blood cultures and time to mortality within 30 days of first positive blood culture. Provider justifications for follow-up blood cultures were identified through chart review. Results: Of 159 eligible patients, 127 (80%) had follow-up blood cultures, including 9 (7%) that were positive for P. aeruginosa and 10 (8%) that were positive for other organisms. Follow-up blood cultures were typically collected to ensure clearance or to guide antibiotic therapy. Overall, 30-day mortality was 25.2%. After risk adjustment for patient characteristics, follow-up blood cultures were associated with a nonsignificant reduction in mortality risk (hazard ratio, 0.43; 95% confidence interval, 1.08; P =.071). In exploratory analyses, the potential mortality reduction from follow-up blood cultures was driven by their use in patients with Pitt bacteremia scores >0. Conclusions: Follow-up blood cultures are commonly collected for P. aeruginosa bacteremia but infrequently identify persistent bacteremia. Targeted use of follow-up blood cultures based on severity of illness may reduce unnecessary culturing. © The Author(s), 2021.
dc.description.sponsorshipInfectious Diseases Society of Americaen_US
dc.description.urihttps://doi.org/10.1017/ash.2021.184en_US
dc.language.isoenen_US
dc.publisherCambridge University Pressen_US
dc.relation.ispartofAntimicrobial Stewardship and Healthcare Epidemiologyen_US
dc.subjectdiagnostic stewardshipen_US
dc.subjectfollow-up blood culturesen_US
dc.subjectPseudomonas aeruginosaen_US
dc.titleFollow-up blood cultures in Pseudomonas aeruginosa bacteremia: A potential target for diagnostic stewardshipen_US
dc.typeArticleen_US
dc.identifier.doi10.1017/ash.2021.184
dc.source.journaltitleAntimicrobial Stewardship and Healthcare Epidemiology
dc.source.volume1
dc.source.issue1


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