Blood Culture Use in Medical and Surgical Intensive Care Units and Wards

作者：Valeria Fabre, Yea‐Jen Hsu, Karen C. Carroll, Alejandra Salinas, Avinash Gadala, Chris Bower, Sarah Boyd, Kathleen Degnan, Pragya Dhaubhadel, Daniel J. Diekema, Marci Drees, Baevin Feeser, Mark Fisher, Cynthia E. Flynn, Bradley Ford, Erin Gettler, Laurel Glaser, Jessica Howard‐Anderson, J. Kristie Johnson, Justin Kim, Marvin Martinez, Amy J. Mathers, Leonard A. Mermel, Rebekah W. Moehring, George E. Nelson, John C. O’Horo, Dana Pepe, Evan D. Robinson, Guillermo Rodriguez‐Nava, Jonathan H. Ryder, Jorge Salinas, Gregory M. Schrank, Aditya Shah, Mark Shelly, Emily S Spivak, Kathleen O. Stewart, Thomas R. Talbot, Trevor Van Schooneveld, Anastasia Wasylyshyn, Sara E. Cosgrove · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2024.54738 · 被引用次数：16 · 研究领域：Bacterial Identification and Susceptibility Testing、Sepsis Diagnosis and Treatment、Neonatal and Maternal Infections

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined. Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals. Design, Setting, and Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted. Critical access hospitals, less than 6 months of BC data, and non-US hospitals were excluded. The study included BC use data from September 1, 2019, to August 31, 2021. Data were analyzed from February 23 to July 14, 2024. Main Outcomes and Measures: The primary outcome was BC use per 1000 patient-days. Adjusted means with 95% CIs were calculated using mixed-effects negative binomial regression models adjusted for unit type, hospital bed size, geographic region, seasonality, and state COVID-19 case load, with random intercepts accounting for clustering at unit and hospital levels. Secondary outcomes included blood culture positivity, single BCs, BC contamination, and minimum threshold for BC use where blood culture positivity would be optimized. Results: A total of 362 327 blood cultures were analyzed from 27 medical ICUs, 35 medical-surgical ICUs, 121 medical wards, and 109 medical-surgical wards from 48 hospitals in 19 states and the District of Columbia. The adjusted mean BC use per 1000 patient-days was 273.1 (95% CI, 270.2-275.9) for medical ICUs, 146...