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Blood cultures - do they make a difference to patient management?

Blood cultures are an expensive test, and optimising the pathway requires considerable effort and commitment. Is it worth the trouble? We looked at 102 consecutive episodes of bacteraemia with clinical details in microbiology system, excluding contaminants and deduplicated to see how it affected patient management.
To spoil the ending, these are the conclusions :

Conclusions

A positive blood culture significantly altered management in 72/102 cases of significant bacteraemia
This was on the basis of
            Gram stain                  27 cases             Culture                       25 cases             Sensitivities                20 cases


There may be debate as to the proportion of septic patients who are bacteraemic (anywhere from 10% to 95% depending on what you believe), but even if we take the lower end of this as being true, bacteraemia would seem an important way of influencing management, even if it is just prompting the microbiologist to get out of the lab and go and re…