PMID- 34307728
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220425
IS  - 2328-8957 (Print)
IS  - 2328-8957 (Electronic)
IS  - 2328-8957 (Linking)
VI  - 8
IP  - 7
DP  - 2021 Jul
TI  - Neither Blood Culture Positivity nor Time to Positivity Is Associated With 
      Mortality Among Patients Presenting With Severe Manifestations of Sepsis: The 
      FABLED Cohort Study.
PG  - ofab321
LID - 10.1093/ofid/ofab321 [doi]
LID - ofab321
AB  - BACKGROUND: Sepsis is a leading cause of morbidity, mortality, and health care 
      costs worldwide. METHODS: We conducted a multicenter, prospective cohort study 
      evaluating the yield of blood cultures drawn before and after empiric 
      antimicrobial administration among adults presenting to the emergency department 
      with severe manifestations of sepsis. Enrolled patients who had the requisite 
      blood cultures drawn were followed for 90 days. We explored the independent 
      association between blood culture positivity and its time to positivity in 
      relation to 90-day mortality. RESULTS: Three hundred twenty-five participants 
      were enrolled; 90-day mortality among the 315 subjects followed up was 25.4% 
      (80/315). Mortality was associated with age (mean age [standard deviation] in 
      those who died was 72.5 [15.8] compared with 62.9 [17.7] years among survivors; P 
      < .0001), greater Charlson Comorbidity Index (2 [interquartile range IQR, 1-3] 
      vs 1 [IQR, 0-3]; P = .008), dementia (13/80 [16.2%] vs 18/235 [7.7%]; P = .03), 
      cancer (27/80 [33.8%] vs 47/235 [20.0%]; P = .015), positive quick Sequential 
      Organ Failure Assessment score (57/80 [71.2%] vs 129/235 [54.9%]; P = .009), and 
      normal white blood cell count (25/80 [31.2%] vs 42/235 [17.9%]; P = .02). The 
      presence of bacteremia, persistent bacteremia after antimicrobial infusion, and 
      shorter time to blood culture positivity were not associated with mortality. 
      Neither the source of infection nor pathogen affected mortality. CONCLUSIONS: 
      Although severe sepsis is an inflammatory condition triggered by infection, its 
      90-day survival is not influenced by blood culture positivity nor its time to 
      positivity. CLINICAL TRIALS REGISTRATION: NCT01867905.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of 
      Infectious Diseases Society of America.
FAU - Paquette, Katryn
AU  - Paquette K
AD  - Division of Neonatology, Montreal Children's Hospital, McGill University, 
      Montreal, Quebec, Canada.
FAU - Sweet, David
AU  - Sweet D
AD  - Division of Critical Care Medicine, Vancouver General Hospital, University of 
      British Columbia, Vancouver, British Columbia, Canada.
FAU - Stenstrom, Robert
AU  - Stenstrom R
AD  - Department of Emergency Medicine, St Paul's Hospital, University of British 
      Columbia, Vancouver, British Columbia, Canada.
FAU - Stabler, Sarah N
AU  - Stabler SN
AD  - Department of Pharmacy Services, Surrey Memorial Hospital, Surrey, British 
      Columbia, Canada.
FAU - Lawandi, Alexander
AU  - Lawandi A
AUID- ORCID: 0000-0001-7948-3161
AD  - Division of Infectious Diseases, McGill University Health Center, McGill 
      University, Montreal, Quebec, Canada.
AD  - Division of Medical Microbiology, McGill University Health Center, McGill 
      University, Montreal, Quebec, Canada.
AD  - National Institutes of Health Clinical Center, Critical Care Department, 
      Bethesda, Maryland, USA.
FAU - Akhter, Murtaza
AU  - Akhter M
AD  - Department of Emergency Medicine, Maricopa Integrated Health Center, Phoenix, 
      Arizona, USA.
FAU - Davidson, Adam C
AU  - Davidson AC
AD  - Department of Emergency Medicine, Lion's Gate Hospital, North Vancouver, British 
      Columbia, Canada.
FAU - Gavric, Marko
AU  - Gavric M
AD  - Division of Critical Care Medicine, Vancouver General Hospital, University of 
      British Columbia, Vancouver, British Columbia, Canada.
FAU - Jinah, Rehman
AU  - Jinah R
AD  - Division of Critical Care Medicine, Vancouver General Hospital, University of 
      British Columbia, Vancouver, British Columbia, Canada.
FAU - Saeed, Zahid
AU  - Saeed Z
AD  - Department of Pulmonary and Critical Care Medicine, University of Arizona College 
      of Medicine, Phoenix, Arizona, USA.
FAU - Demir, Koray
AU  - Demir K
AD  - Department of Medicine, McGill University, Montreal, Quebec, Canada.
FAU - Sangsari, Sassan
AU  - Sangsari S
AD  - Department of Emergency Medicine, Vancouver General Hospital, University of 
      British Columbia, Vancouver, British Columbia, Canada.
FAU - Huang, Kelly
AU  - Huang K
AD  - Department of Emergency Medicine, Vancouver General Hospital, University of 
      British Columbia, Vancouver, British Columbia, Canada.
FAU - Mahpour, Amirali
AU  - Mahpour A
AD  - Division of Respirology, University of Western Ontario, London Health Sciences 
      Center, London, Ontario, Canada.
FAU - Shamatutu, Chris
AU  - Shamatutu C
AD  - Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, 
      Canada.
FAU - Caya, Chelsea
AU  - Caya C
AD  - Department of Medicine, McGill University, Montreal, Quebec, Canada.
FAU - Troquet, Jean-Marc
AU  - Troquet JM
AD  - Department of Emergency Medicine, McGill University Health Centre, Montreal, 
      Quebec, Canada.
FAU - Clark, Greg
AU  - Clark G
AD  - Department of Emergency Medicine, McGill University Health Centre, Montreal, 
      Quebec, Canada.
FAU - Wong, Titus
AU  - Wong T
AD  - Department of Medical Microbiology, Vancouver Coastal Health, Vancouver, British 
      Columbia, Canada.
FAU - Yansouni, Cedric P
AU  - Yansouni CP
AUID- ORCID: 0000-0002-4765-3469
AD  - Division of Infectious Diseases, McGill University Health Center, McGill 
      University, Montreal, Quebec, Canada.
AD  - Division of Medical Microbiology, McGill University Health Center, McGill 
      University, Montreal, Quebec, Canada.
FAU - Cheng, Matthew P
AU  - Cheng MP
AUID- ORCID: 0000-0002-4867-2063
AD  - Division of Infectious Diseases, McGill University Health Center, McGill 
      University, Montreal, Quebec, Canada.
AD  - Division of Medical Microbiology, McGill University Health Center, McGill 
      University, Montreal, Quebec, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT01867905
PT  - Journal Article
DEP - 20210617
PL  - United States
TA  - Open Forum Infect Dis
JT  - Open forum infectious diseases
JID - 101637045
PMC - PMC8294679
OTO - NOTNLM
OT  - bacteremia
OT  - bloodstream infection
OT  - mortality
OT  - sepsis
OT  - survival
EDAT- 2021/07/27 06:00
MHDA- 2021/07/27 06:01
PMCR- 2021/06/17
CRDT- 2021/07/26 06:40
PHST- 2021/02/11 00:00 [received]
PHST- 2021/06/15 00:00 [accepted]
PHST- 2021/07/26 06:40 [entrez]
PHST- 2021/07/27 06:00 [pubmed]
PHST- 2021/07/27 06:01 [medline]
PHST- 2021/06/17 00:00 [pmc-release]
AID - ofab321 [pii]
AID - 10.1093/ofid/ofab321 [doi]
PST - epublish
SO  - Open Forum Infect Dis. 2021 Jun 17;8(7):ofab321. doi: 10.1093/ofid/ofab321. 
      eCollection 2021 Jul.