ASSOCIATION BETWEEN BLOOD GLUCOSE LEVEL AT THE TIME OF BLOOD CULTURE
SAMPLING AND CULTURE POSITIVITY IN A MEDICAL INTENSIVE CARE UNIT: A
PROSPECTIVE OBSERVATIONAL STUDY
Abstract
Introduction Sepsis is one of the major causes of death in intensive
care unit (ICU). One of the most important treatment for sepsis is
antibiotic treatment. At the beginning antibiotics is chosen empirically
after that is changed according to culture results or response to
initial treatment. Nevertheless, only small number of culture positivity
can be detected. The factors associated culture positivity are of
interest in the critically ill patients. Therefore, we aim in our study
to explore the factors associated with blood culture positivity
especially blood glucose levels at the time blood culture sampling.
Methods We perform this prospective observational study at the Intensive
Care Unit of Dr. Suat Seren Chest Disease and Chest Surgery Training and
Research Hospital between August 1, 2016 and January 1, 2017, in İzmir,
Turkey. Two separate samples from opposite sides of each patient were
obtained, and blood glucose was measured simultaneously with bed-side
blood glucose measurement device by using the blood drawn for blood
culture for each vial. The average of the two measurements was
considered as the simultaneous blood glucose level of the patient.
Results 174 patients were enrolled into the study, blood culture
positivity was detected in 53 (30%) patients. In univariate analyzes,
blood glucose levels, presence of central venous catheter, antibiotic
treatment, vasoactive drug infusion and diabetes mellitus (DM) were
associated with culture positivity. In multivariate analyze only DM was
associated culture positivity (OR 5.63 [95% CI 1.99-15.91]
p=0,001). Conclusion DM increase possibility of blood culture
positivity. It stems from uncontrolled DM. Further studies are needed to
evaluate this condition stems from uncontrolled DM or both uncontrolled
and well-controlled DM.