Observational studyThe American journal of medicine2019
Utility of Blood Cultures in Pneumonia.
Observational study in The American journal of medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 47 citations in OpenAlex.
- Diagnostic value of metagenomic next-generation sequencing for bacterial and fungal detection and its role in antimicrobial therapy adjustment in critically ill patients with non-resolving pneumonia.Annals of medicine · 2026Article
- Teaching to the Test: Threading the Needle on Sepsis Quality Metrics.Journal of general internal medicine · 2026Article
- An interpretable machine-learning model for post-admission reassessment of bloodstream infection risk in ICU patients with pneumonia.Scientific reports · 2026Article
- Clinical Utility and Therapeutic Strategy Value of Metagenomic Next-Generation Sequencing in Pulmonary Infection Among Cancer Patients.Infection and drug resistance · 2026Article
- Distinct systemic metabolic phenotypes associated with blood culture positivity and bacterial etiology in community-acquired pneumonia (CAP).Frontiers in cellular and infection microbiology · 2026Article
- Epidemiological analysis of pediatric respiratory pathogens in Hunan, China: a retrospective multicenter study from 2022 to 2024.BMC infectious diseases · 2025Article
- Article
- Antibiotic de-escalation patterns and outcomes in critically ill patients with suspected pneumonia as informed by bronchoalveolar lavage results.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Development of a Rapid, Culture-Free, Universal Microbial Identification System Using Internal Transcribed Spacer Targeting Primers.The Journal of infectious diseases · 2025Article
- Etiology of Hospital-Acquired Pneumonia (HAP) and Ventilator-Associated Pneumonia (VAP) in Tertiary-Care Hospitals in Thailand: A Multicenter, Retrospective Cohort Study.Infection and drug resistance · 2025Article
- Clinical characteristics of pathogens in children with community-acquired pneumonia were analyzedPeerJ · 2025Article
- A Review on Risk Factors, Traditional Diagnostic Techniques, and Biomarkers for Pneumonia Prognostication and Management in Diabetic Patients.Diseases (Basel, Switzerland) · 2024Review
- High utility of bronchoalveolar lavage fluid metagenomic next-generation sequencing approach for etiological diagnosis of pneumonia.BMC infectious diseases · 2024Article
- Clinical application of nanopore-targeted sequencing technology in bronchoalveolar lavage fluid from patients with pulmonary infections.Microbiology spectrum · 2024Article
- Diagnostic and prognostic implications of bacteremia in patients with complicated pleural infection.Pleura and peritoneum · 2024Article
- Optimizing Diagnosis and Management of Community-acquired Pneumonia in the Emergency Department.Emergency medicine clinics of North America · 2024Review
- Article
- Plasma Microbial Cell-Free DNA Sequencing in Immunocompromised Patients With Pneumonia: A Prospective Observational Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Observational
- Diagnostic performance of metagenomic sequencing in patients with suspected infection: a large-scale retrospective study.Frontiers in cellular and infection microbiology · 2024Article
- A comparison of National Healthcare Safety Network surveillance definitions to physician review for central-line-associated bloodstream infections.Infection control and hospital epidemiology · 2023Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
introductionBlood cultures are of limited utility in nonsevere community-acquired pneumonia, though routinely recommended for severe community-acquired pneumonia or health care-associated pneumonia due to perceived greater bacteremia risk, particularly with multidrug-resistant organisms. The utility of this practice is unknown.
methodsIn this observational cohort study, we abstracted data from medical records for consecutive hospitalizations for pneumonia by adults to an academic medical center from 2014-2015. The primary outcomes included bacteremia, multidrug-resistant organism bacteremia, and appropriate management changes attributed to culture results, stratified by pneumonia classification (nonsevere community-acquired pneumonia, severe community-acquired pneumonia, or health care-associated pneumonia) and likelihood the bacteremia was due to pneumonia vs another infection. We assessed the diagnostic test performance of one or more guideline-defined risk factors for bacteremia in nonsevere community-acquired pneumonia, for whom cultures are routinely recommended.
resultsOf 456 pneumonia hospitalizations, 30 (6.6%) had bacteremia, with a greater incidence in severe community-acquired pneumonia (14.7%) than nonsevere community-acquired pneumonia (7.8%) and health care-associated pneumonia (6.6%; P = .12). Seventeen bacteremia cases were likely due to pneumonia (3.7%). Only 2 (0.4%) had multidrug-resistant organisms (both health care-associated pneumonia), one of whom was due to pneumonia. Appropriate management changes occurred in 8 cases (1.8%; 7 de-escalation and 1 escalation of antibiotics); only 1 with bacteremia likely due to pneumonia (de-escalation). The one case of appropriate antibiotic escalation occurred in a patient with vancomycin-resistant Enterococcus unrelated to pneumonia. Having one or more guideline-defined risk factors did not identify bacteremia in nonsevere community-acquired pneumonia (positive likelihood ratio, 1.10; 95% confidence interval, 0.61-1.99).
conclusionRoutine blood cultures in pneumonia have extremely low yield and utility irrespective of severity and risk.
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Registered trials
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