Diagnostic and therapeutic yield of imaging studies in Polymicrobial and Monomicrobial Gram-negative bloodstream infections - a retrospective cohort study

Diagn Microbiol Infect Dis. 2024 Sep;110(1):116366. doi: 10.1016/j.diagmicrobio.2024.116366. Epub 2024 May 19.

Abstract

Purpose: Appropriate antimicrobial therapy and surgical drainage, improve survival in patients with Gram negative bloodstream infections (BSI). Data about the yield of imaging studies in polymicrobial BSI is sparse. The aim of the study was to assess the need for imaging studies and surgical drainage among patients with polymicrobial compared to monomicrobial BSI.

Results: In a retrospective cohort study of adult patients with Gram negative BSI, 135 patients with monomicrobial BSI were compared to 82 with polymicrobial BSI. Imaging studies were performed in 56.3 % of patients with monomicrobial BSI and in 50 % of polymicrobial BSI (p=0.4), surgical drainage was performed in 20.1 % of patients with monomicrobial BSI and 27.2 % of polymicrobial BSI (p=0.25). Surgical drainage was performed in 26.2 % of patients who survived vs. 11.8 % of patients who died (p=0.035).

Conclusions: There is no difference in the diagnostic approach to monomicrobial and polymicrobial Gram-negative BSI. Surgical drainage is associated with decreased mortality.

Keywords: Bacteremia; Bloodstream infection; Diagnostic approach; Gram negative; Imaging studies; Polymicrobial.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / diagnosis
  • Bacteremia* / drug therapy
  • Bacteremia* / microbiology
  • Bacteremia* / mortality
  • Coinfection* / diagnosis
  • Coinfection* / microbiology
  • Drainage / methods
  • Female
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections* / diagnosis
  • Gram-Negative Bacterial Infections* / drug therapy
  • Gram-Negative Bacterial Infections* / microbiology
  • Gram-Negative Bacterial Infections* / mortality
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents