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Updated: Sep 13, 2025
Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
Published on: October 15, 2014
Blood Culture Positivity and Clinical Correlates of Bloodstream Infections in Post-cardiac Surgery Patients
Jonathan M Curley1, Akram M Zaaqoq1, Siny Tsang1
1Department of Anesthesiology, University of Virginia Health, Charlottesville, VA.
Objective:
To describe the positivity rate of blood cultures in postoperative cardiac surgical patients and identify clinical variables associated with bloodstream infection (BSI).
Design:
Retrospective cohort study.
Setting:
Single center.
Participants:
All post-cardiac surgery intensive care unit patients for whom blood cultures were obtained between July 1, 2018, and June 30, 2023, were included. Patients were identified using the institution's Society of Thoracic Surgeons (STS) database.
Interventions:
None.
Measurements And Main Results:
For all patients, clinical variables and demographics were retrospectively obtained from the authors' institution's electronic medical record. During the study period, 3,095 patients underwent cardiac surgery, and 533 (17.2%) of them had blood cultures performed, resulting in a total of 1,294 cultures. The median day of culture acquisition was postoperative day 13 after the index surgery. Of the 1,294 cultures, 115 (8.9%) demonstrated BSI. Multivariate generalized linear mixed-effects regression analysis identified the following clinical variables to be independently associated with BSI: total parental nutrition in the 48 hours prior (odds ratio [OR] = 5.44, 95% confidence interval [CI] = 2.07, 14.30), severe thrombocytopenia (OR = 3.75, 95% CI = 1.75, 8.04), end-stage renal disease (OR = 2.19, 95% CI = 1.01, 4.78), mechanical ventilation during the 48 hours prior (OR = 1.92, 95% CI = 1.10, 3.36), and heart rate >100 in the 24 hours prior (OR = 1.70, 95% CI = 1.03, 2.79). Notably, neither fever nor leukocytosis was associated with culture-positive BSI.
Conclusions:
In a single-center cohort of cardiac surgical patients, end-stage renal disease, tachycardia, recent mechanical ventilation, severe thrombocytopenia, and total parental nutrition were associated with BSI. Leukocytosis and fever were not found to be associated with culture-positive BSI. These risk factors should be validated in a prospective cohort study so that clinicians can better identify which patients are most likely to have BSI.
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