Abstract

DIAZ PARODI, Germán Ignacio  and  MUSACCHIO, Héctor Mario. Evaluation of clinical predictors of bacteremia in adults hospitalized for community-acquired pneumonia. Rev Panam Salud Publica [online]. 2011, vol.29, n.6, pp. 393-398. ISSN 1020-4989.  http://dx.doi.org/10.1590/S1020-49892011000600002.

OBJECTIVE: Identify simple clinical elements that can be used to adequately determine the cases with the highest probability of presenting bacterial isolates in blood cultures. METHODS: Case-control study with patients hospitalized for community-acquired pneumonia from 1998-2009. Patients with positive blood cultures were defined as cases, and patients with negative blood cultures were defined as controls. The demographic and clinical variables were recorded and a bivariate analysis was conducted. The variables with statistically significant differences between the groups were introduced in a logistic regression model in order to define the independent predictors and generate a clinical prediction model. RESULTS: A total of 15.2% of the 322 patients studied had positive blood cultures. Ten variables showed significant differences, but only three variables (temperature <38°C, sodium <135 mEq/L and CURB-65 score) were selected for the multivariate analysis. The model developed showed limited capacity to predict the result of the blood cultures (R² = 0.176; Hosmer-Lemeshow: P = 0.338). CONCLUSIONS: The data obtained in this series did not demonstrate clinical elements with sufficient capacity to predict the result of the blood cultures.

Keywords : Pneumonia; bacteremia; bacteriological techniques; laboratory techniques and procedures; Argentina.