Positive blood cultures in outpatients: predictors of poor outcome

Abstract

Introduction : Blood culture is a standard diagnostic test for bacteremia. In patients with suspected bacteremia who are treated as outpatients, blood cultures are commonly performed before discharge.

Objective : To identify the predictors of poor outcome in patients discharged from the Outpatient Department (OPD) and the Emergency Departments (ED).

Setting : King Chulalongkorn Memorial Hospital

Research design : A retrospective study based on medical record review.

Patients : All patients with positive blood culture who were treated as outpatients from September 2005 to December 2006.

Methods : Demographic data, history of present illness, medical history, physical examination, and laboratory investigation of 53 eligible patients were retrospectively reviewed. Univariate and multivariate analyses were used to identify independent prediction factors of poor outcome.

Results : Hemoglobin in patients with poor treatment outcome was significantly lower than those with good outcome. (9.9 vs 11.8 g/dl, p < 0.05). No significant difference in the age, WBC count, percentage of neutrophils, antibiotic administration before discharge, and proportion of true pathogen in positive blood culture was demonstrated among patients with good and poor outcome.

Conclusion :In this study low hemoglobin was shown to be a predictor of poor outcome in hemoculture-positive outpatients.