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. 2020 Sep 9;20(1):665.
doi: 10.1186/s12879-020-05257-3.

Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia

Huiting Xu  1   2 , Jie Cheng  1   2 , Qinghong Yu  1   2 , Qingyuan Li  1   2 , Qian Yi  1   2 , Siying Luo  1   2 , Yuanyuan Li  3 , Guangli Zhang  3 , Xiaoyin Tian  3 , Dapeng Cheng  4 , Zhengxiu Luo  5
Affiliations

Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia

Huiting Xu et al. BMC Infect Dis. .

Abstract

Background: Pseudomonas aeruginosa (P. aeruginosa) is a major Gram-negative pathogen, which has been reported to result in high mortality. We aim to investigate the prognostic value and optimum cut-off point of time-to-positivity (TTP) of blood culture in children with P. aeruginosa bacteremia.

Methods: From August 2014 to November 2018, we enrolled the inpatients with P. aeruginosa bacteremia in a 1500-bed tertiary teaching hospital in Chongqing, China retrospectively. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off point of TTP, and logistic regression were employed to explore the risk factors for in-hospital mortality and septic shock.

Results: Totally, 52 children with P. aeruginosa bacteremia were enrolled. The standard cut-off point of TTP was18 h. Early TTP (≤18 h) group patients had remarkably higher in-hospital mortality (42.9% vs 9.7%, P = 0.014), higher incidence of septic shock (52.4% vs12.9%, P = 0.06), higher Pitt bacteremia scores [3.00 (1.00-5.00) vs 1.00 (1.00-4.00), P = 0.046] and more intensive care unit admission (61.9% vs 22.6%, P = 0.008) when compared with late TTP (> 18 h) groups. Multivariate analysis indicated TTP ≤18 h, Pitt bacteremia scores ≥4 were the independent risk factors for in-hospital mortality (OR 5.88, 95%CI 1.21-21.96, P = 0.035; OR 4.95, 95%CI 1.26-27.50, P = 0.024; respectively). The independent risk factors for septic shock were as follows: TTP ≤18 h, Pitt bacteremia scores ≥4 and hypoalbuminemia (OR 6.30, 95%CI 1.18-33.77, P = 0.032; OR 8.15, 95%CI 1.15-42.43, P = 0.014; OR 6.46, 95% CI 1.19-33.19 P = 0.031; respectively).

Conclusions: Early TTP (≤18 hours) appeared to be associated with worse outcomes for P. aeruginosa bacteremia children.

Keywords: Bacteremia; Children; Outcomes; Pseudomonas aeruginosa; Time to positivity.

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Conflict of interest statement

The authors declare no financial and non-financial competing interests.

Figures

Fig. 1
Fig. 1
ROC (receiver operating characteristic) curves of TTP (Time-to-positivity). AUC stands for area under the curve
Fig. 2
Fig. 2
The Kaplan–Meier survival curve of 52 children with P. aeruginosa bacteremia according to in-hospital mortality. Patients were divided into early and late TTP groups according to the optimal TTP cut-off points
Fig. 3
Fig. 3
The Kaplan–Meier survival curve of 52 children with P. aeruginosa bacteremia according to septic shock incidence. Patients were divided into early and late TTP groups according to the optimal TTP cut-off points
See this image and copyright information in PMC

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