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. 2019;31(6):399-403.

Seasonality of bacteremia cases in an emergency department

[Article in Spanish, English]
José María Ferreras Amez  1 , Belén Arribas Entrala  2 , Carmen Aspiroz  3 , Ana Ezpeleta Galindo  4 , Beatriz Boned Juliani  5
Affiliations
  • PMID: 31777211
Free article

Seasonality of bacteremia cases in an emergency department

[Article in Spanish, English]
José María Ferreras Amez et al. Emergencias. 2019.
Free article

Abstract
in English, Spanish

Objectives: To assess seasonal variation in episodes of bacteremia.

Material and methods: Retrospective cohort study of cases of significant bacteremia found in blood cultures ordered in a hospital emergency department. The incidence, etiology, diagnostic and prognostic yield were analyzed for each season of the year.

Results: A total of 4384 blood cultures were ordered in 4.1% of the emergency patients attended. The diagnostic yield was 12.2% (incidence, 490 cases per 100 000 cases attended). Cultures were ordered more often in winter (in 4.6% of the patients vs in 3.8% in the other seasons on average, P<.001). The diagnostic yield was lower in winter than in the other seasons (10.2% vs 13%, P=.01), and the contamination rate was higher (4.9% vs 3.8%, P=.02). Escherichia coli was isolated in fewer cultures in winter than in other seasons (36.4% vs 46.9%, P=.03), and Streptococcus pneumoniae was isolated in more (14.5% vs 5.9%, P=.001).

Conclusion: The microbiological profile of blood cultures, their diagnostic yield, and rate of contamination differ greatly in winter.

Objetivo: Valorar la variabilidad de la estacionalidad en los episodios de bacteriemia.

Metodo: Estudio de cohortes retrospectivo de las bacteriemias significativas de los hemocultivos extraídos en un servicio de urgencias. Se analizó la incidencia, etiología, rentabilidad y pronóstico, así como las variaciones en función de las estaciones del año.

Resultados: Se realizaron 4.384 solicitudes de hemocultivos, que representó una tasa de solicitud del 4,1%. La rentabilidad diagnóstica fue del 12,2%. La incidencia de bacteriemia fue de 490 episodios por cada 100.000 atenciones. En invierno, respecto a la media del resto de estaciones, resultaron significativos el incremento en la solicitud de hemocultivos (4,6% frente a 3,8%, p < 0,001), el descenso de la rentabilidad diagnóstica (10,2% frente a 13%, p = 0,01), el incremento en la tasa de contaminación (4,9 % frente a 3,8%, p = 0,02), una menor frecuencia de aislamientos de Escherichia coli (36,4% frente a 46,9%, p = 0,03) y mayor de Streptococcus pneumoniae (14,5% frente a 5,9%, p = 0,001).

Conclusiones: Se identifica una variabilidad significativa en cuanto al perfil microbiológico, rentabilidad y contaminantes en los hemocultivos obtenidos durante la estación invernal.

Keywords: Bacteremia; Hemocultivos; Mortality; Bacteriemia; Blood cultures; Emergency department; Mortalidad; Sepsis; Septicemia; Servicio de Urgencias.

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