Predicting Bacteremia at the Bedside

Abstract

Our aim was to develop a clinical prediction rule for detection of bacteremia in a cohort of patients observed prospectively at a reference center in Medellín, Colombia. The significant predictors of bacteremia were an age of ≥30 years (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.19-3.60), a heart rate of ≥90 beats/ min (OR, 1.90; 95% CI, 1.13-3.17), a temperature of ≥37.8°C (OR, 2.42; 95% CI, 1.41-4.14), a leukocyte count of ≥12,000 cells/μL (OR, 2.40; 95% CI, 1.41-4.10), use of a central venous catheter (OR, 1.89; 95% CI, 1.02-3.50), and a length of hospitalization of ≥10 days (OR, 2.02; 95% CI, 1.25-3.24). The Hosmer-Lemeshow test revealed a goodness-of-fit of 2.99 (P = .981), and the area under the receiver operating characteristics curve was 0.7186. Simple variables obtained from the clinical history of patients are associated with bloodstream infection in a reproducible fashion and should be instrumental for prioritizing the requests for blood cultures by clinicians.