Impact of reporting gram stain results from blood culture bottles on the selection of antimicrobial agents

Yuki Uehara, Michiko Yagoshi, Yumiko Tanimichi, Hiroko Yamada, Kazuo Shimoguchi, Sachiyo Yamamoto, Mitsuru Yanai, Kazunari Kumasaka

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)

Abstract

We assessed the usefulness of reporting direct blood Gram stain results compared with the results of positive blood cultures in 482 episodes and monitored impact on selection of antimicrobial treatment. We found that the reporting groups "Staphylococcus spp," "Pseudomonas spp and related organisms," and "yeasts" identified in this way matched perfectly with later culture identification. When the report indicated Staphylococcus spp or Pseudomonas spp and related organisms, physicians started or changed antimicrobials suitable for these bacteria more frequently than when "other streptococci" and "family Enterobacteriaceae" were reported (P < .05). Incorrect recognition of Acinetobacter spp as Enterobacteriaceae family is still the most challenging problem in this context. Gram stain results that definitively identify Staphylococcus spp, Pseudomonas spp and related organisms, and yeasts reliably can be rapidly provided by clinical laboratories; this information has a significant impact on early selection of effective antimicrobials. Further investigation is needed to assess the clinical impact of reporting Gram stain results in bacteremia.

Original languageEnglish
Pages (from-to)18-25
Number of pages8
JournalAmerican Journal of Clinical Pathology
Volume132
Issue number1
DOIs
Publication statusPublished - 07-2009
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

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