Infective endocarditis: two sets of blood cultures detected 99% of cases of septicaemia.
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Clinical bottom line (level 4)
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Almost all cases of septicaemia were detected following culture of two sets of blood cultures.
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There was little to be gained in doing more than this.
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Weinstein
et al: Review of Infectious Diseases
1983;
5:
35-53
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Expires
July 2003
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The study
Setting: university hospital and veterans' hospital, USA, 1975 to 1977
282 patients
(aged
?,
62%
male)
positive blood cultures
Excluded if
- presence or absence of a particular finding was not clearly indicated on a chart
Non-independent unblinded
reference standard, applied in
all
patients from a
consecutive ?appropriate
spectrum.
Reference standard:
- 'true septicaemia'- based on multiple factors, including history of the patient, examination, body temperature, peripheral leukocyte count and differential, clinical course, and results of cultures from other body sited, and percentage of blood cultures positive
Diagnostic test:
blood culture (15 ml of blood taken: 5 ml inoculated into three bottles and cultures for 14 days)
The evidence
| diagnostic test |
number of patients |
sensitivity for
positive blood culture
(95% CI) |
| first blood culture |
258/282 |
92%
(88% to
95%)
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| second blood culture |
280/282 |
99%
(98% to
100%)
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| third blood culture |
281/282 |
100%
(99% to
100%)
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| total |
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- The overall incidence of septicaemia at UCH and DVAH was 12.5 episodes/1000 admissions.
Citation
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Weinstein
MP,
et al:
The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteraemia and fungaemia in adults. Review of Infectious Diseases
1983;
5:
35-53
Search Terms:
blood cultures and diagnosis
Contributor: Sumit Dhingra, Carl Heneghan and Chris Ball,
July 2000
Reviewer:
Clinical Question.
| Patient |
suspected endocarditis |
| Intervention or Exposure |
repeated blood cultures, two sets, three sets |
| Outcome |
prevalence of positive sets |
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