Lee and Kim evaluated the significance of blood cultures in patients with community-onset pneumonia. The authors are from Jeju National University Hospital and Kyung Hee University in Korea.
Patient selection: community-onset pneumonia (community-acquired or healthcare-acquired)
Outcome: true bacteremia versus false negative or false positive (contaminant)
Predictors of true bacteremia:
(1) chronic liver disease (odds ratio 3)
(2) CURB-65 score of 4 or 5 (odds ratio 3.5)
(3) Pneumonia Severity Index (PSI) of class V (odds ratio 2.4)
Body temperature < 35 or >= 40°C was not considered associated probably because the p value was 0.056. However, its odds ratio is 15.
PSI or CURB-65 were superior to CRP for predicting true bacteremia
True bacteremia:
(1) was associated with higher in-hospital mortality
(2) may isolate an organism requiring adjustment of antibiotic therapy
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