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. 2022 Aug 31;10(4):e0022822.
doi: 10.1128/spectrum.00228-22. Epub 2022 Jun 28.

Little Utility of Fungal Blood Cultures in Surgical and Burn Intensive Care Units

Jacqueline Babb  1   2 , Audra Clark  1   2 , Donna Gaffney  2 , Kareem Abdelfattah  1   2 , Bonnie C Prokesch  3
Affiliations

Little Utility of Fungal Blood Cultures in Surgical and Burn Intensive Care Units

Jacqueline Babb et al. Microbiol Spectr. .

Abstract

Critically ill patients are at risk for fungal infections, but there is a paucity of data regarding the clinical utility of dedicated fungal blood cultures to detect such infections. A retrospective review was conducted of patients admitted to the surgical and burn intensive care units at Parkland Memorial Hospital between 1 January 2013 and 31 December 2017 for whom blood cultures (aerobic, anaerobic, and/or fungal cultures) were sent. A total of 1,094 aerobic and anaerobic blood culture sets and 523 fungal blood cultures were sent. Of the aerobic and anaerobic culture sets, 42/1,094 (3.8%) were positive for fungal growth. All fungal species cultured were Candida. Of the fungal blood cultures, 4/523 (0.76%) were positive for growth. Fungal species isolated included Candida albicans, Aspergillus fumigatus, and Histoplasma capsulatum. All 4 patients with positive fungal blood cultures were on empirical antifungal therapy prior to results, and the antifungal regimen was changed for 1 patient based on culture data. The average duration to final fungal culture result was 46 days, while the time to preliminary results varied dramatically. Two of the four patients died prior to fungal culture results, thereby rendering the culture data inconsequential in patient care decisions. This study demonstrates that regular aerobic and anaerobic blood cultures sets are sufficient in detecting the most common causes of fungemia and that results from fungal cultures rarely impact treatment management decisions in patients in surgical and burn intensive care units. There is little clinical utility to routine fungal cultures in this patient population. IMPORTANCE This study demonstrates that regular aerobic and anaerobic blood culture sets are sufficient in detecting the most common causes of fungemia, and thus, sending fungal blood cultures for patients in surgical and burn intensive care units is not a good use of resources.

Keywords: ICU; blood culture; candidemia; critical care; fungemia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIG 1
FIG 1
Positive fungal culture results from aerobic and anaerobic blood cultures.
FIG 2
FIG 2
Fungal species isolated on aerobic and anaerobic blood cultures.
See this image and copyright information in PMC

References

    1. Blumberg HM, Jarvis WR, Soucie JM, Edwards JE, Patterson JE, Pfaller MA, Rangel-Frausto MS, Rinaldi MG, Saiman L, Wiblin RT, Wenzel RP, National Epidemiology of Mycoses Survey (NEMIS) Study Group . 2001. Risk factors for candidal bloodstream infections in surgical intensive care unit patients: the NEMIS prospective multicenter study. The National Epidemiology of Mycosis Survey. Clin Infect Dis 33:177–186. doi: 10.1086/321811. - DOI - PubMed
    1. Trick WE, Fridkin SK, Edwards JR, Hajjeh RA, Gaynes RP, the National Nosocomial Infections Surveillance System Hospitals . 2002. Secular trend of hospital-acquired candidemia among intensive care unit patients in the United States during 1989–1999. Clin Infect Dis 35:627–630. doi: 10.1086/342300. - DOI - PubMed
    1. NNIS System. 2003. National Nosocomial Infections Surveillance (NNIS) system report 2003. Data summary from January 1992 through June 2003, issued August 2003. Am J Infect Control 31:481–498. doi: 10.1016/j.ajic.2003.09.002. - DOI - PubMed
    1. Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP. 1989. Risk factors for hospital-acquired candidemia: a matched case-control study. Arch Intern Med 149:2349–2353. doi: 10.1001/archinte.1989.00390100145030. - DOI - PubMed
    1. Bassetti M, Azoulay E, Kullberg B-J, Ruhnke M, Shoham S, Vazquez J, Giacobbe DR, Calandra T. 2021. EORTC/MSGERC definitions of invasive fungal diseases: summary of activities of the Intensive Care Unit Working Group. Clin Infect Dis 72:S121–S127. doi: 10.1093/cid/ciaa1751. - DOI - PubMed

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