Diagnostic accuracy of time to first positivity of blood cultures for predicting severe clinical outcomes in children with pneumonia-related bacteremia

Early recognition of severe clinical outcomes in children with pneumonia-related bacteremia is vitally important because of the high mortality. This study aims to explore risk factors for severe clinical outcomes in children with pneumonia-related bacteremia and evaluate the value of time to first p...

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Published in:Journal of investigative medicine 2020-10, Vol.68 (7), p.1241-1249
Main Authors: Zhang, Yin, Lin, Jilei, Shi, Qingxia, Li, Chulin, Liu, Jingyue, Dai, Jihong
Format: Article
Language:English
Subjects:
Antibiotics
Bacteria
Bacterial infections
Blood
Cardiovascular disease
Clinical outcomes
Congenital diseases
Dehydrogenases
Fever
Gram-positive bacteria
Hospitals
Laboratories
Meningitis
Mortality
Pathogens
Pediatrics
Pneumonia
Pneumothorax
Sepsis
Streptococcus infections
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Summary:Early recognition of severe clinical outcomes in children with pneumonia-related bacteremia is vitally important because of the high mortality. This study aims to explore risk factors for severe clinical outcomes in children with pneumonia-related bacteremia and evaluate the value of time to first positive blood cultures (TTFP) in predicting prognosis. Children with pneumonia-related bacteremia in Children’s Hospital of Chongqing Medical University were included (January 2013–May 2019), respectively. TTFP and clinical parameters were collected and analyzed. The area under the curve (AUC)-receiver operating characteristic was used to evaluate the discrimination ability of TTFP. Multivariate logistic regression tests were performed to evaluate the association between TTFP and severe clinical outcomes. A total of 242 children with pneumonia-related bacteremia were included. The least absolute shrinkage and selection operator (LASSO) regression analysis identified TTFP, serum albumin (ALB) and lactic dehydrogenase (LDH) as predictors of in-hospital mortality. Multivariate logistic regression analysis showed that shorter TTFP (OR 0.94; 95% CI 0.89 to 0.97; p
ISSN:1081-5589
1708-8267
DOI:10.1136/jim-2020-001473