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Risk factors associated with apyrexia during bacteraemia: a prospective multicenter cohort study
Pierre-Marie Roger1,2, Lucie Bocquillon3, Arnaud Lemasson4
1, Infectiologie, Clinique Les Fleurs, 332, Ave Frédéric Mistral, Ollioules, 83190, France. roger@elsan.care.
Summary
Apyrexia (absence of fever) during bacteremia is common, especially in oncology patients and those with Enterococcus infections. Urinary tract infections, however, protect against apyrexia in bacteremia.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Apyrexia during bacteremia is frequently observed, leading to diagnostic challenges.
- Identifying risk factors for apyrexia in bacteremic patients is crucial for timely diagnosis and management.
Purpose of the Study:
- To investigate the risk factors associated with apyrexia in patients diagnosed with bacteremia.
- To improve the understanding of clinical presentations of bacteremia beyond fever.
Main Methods:
- Prospective, bicentric study of positive blood cultures (PBC) over 27 months.
- Exclusion of contaminated cultures; data collected from digital medical files.
- Logistic regression analysis to identify risk factors for apyrexia despite bacteremia.
Main Results:
- Out of 352 bacteremia cases, 20% presented with apyrexia.
- Apyrexia was significantly associated with lack of prior antibiotic prescription (35% vs 13%).
- Risk factors for apyrexia included oncology admission (aOR 2.03) and enterococcal bacteremia (aOR 4.01); urinary infections were protective (aOR 0.16).
Conclusions:
- Apyrexia in bacteremia is not uncommon, particularly outside of urinary tract infections.
- Oncology admission and Enterococcus spp. bacteremia are key risk factors for apyrexia.
- Urinary tract infections appear to be a protective factor against apyrexia in bacteremic patients.
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