Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 132, Issue 1, Pages 18-25Publisher
OXFORD UNIV PRESS INC
DOI: 10.1309/AJCP0H2DAMBXZUSS
Keywords
Blood culture; Gram stain; Antimicrobials; Empiric therapy
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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.
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