Details:

Alternative Title:
Clin Infect Dis
Publisher's site:
http://dx.doi.org/10.1093/cid/ciaa1333
Personal Author:
Vaidya, Krista ; Aiemjoy, Kristen ; Qamar, Farah N ; Saha, Samir K ; Tamrakar, Dipesh ; ... More +
Vaidya, Krista ; Aiemjoy, Kristen ; Qamar, Farah N ; Saha, Samir K ; Tamrakar, Dipesh ; Naga, Shiva R ; Saha, Shampa ; Hemlock, Caitlin ; Longley, Ashley T ; Date, Kashmira ; Bogoch, Isaac I ; Garrett, Denise O ; Luby, Stephen P ; Andrews, Jason R Less -
Description:
Background

Antibiotic use prior to seeking care at a hospital may reduce the sensitivity of blood culture for enteric fever, with implications for both clinical care and surveillance. The Surveillance for Enteric Fever in Asia Project (SEAP) is a prospective study of enteric fever incidence in Nepal, Bangladesh, and Pakistan. Nested within SEAP, we evaluated the accuracy of self-reported antibiotic use and investigated the association between antibiotic use and blood culture positivity.

Methods

Between November 2016 and April 2019, we collected urine samples among a subset of SEAP participants to test for antibiotic use prior to the hospital visit using an antibacterial activity assay. All participants were asked about recent antibiotic use and had a blood culture performed. We used mixed-effect logit models to evaluate the effect of antimicrobial use on blood culture positivity, adjusted for markers of disease severity.

Results

We enrolled 2939 patients with suspected enteric fever. Antibiotics were detected in 39% (1145/2939) of urine samples. The correlation between measured and reported antibiotic use was modest (κ = 0.72). After adjusting for disease severity, patients with antibiotics in their urine were slightly more likely to be blood culture positive for enteric fever; however, the effect was not statistically significant (prevalence ratio, 1.22 [95% confidence interval, .99–1.50]).

Conclusions

The reliability of self-reported prior antibiotic use was modest among individuals presenting with fever to tertiary hospitals. While antibiotics are likely to reduce the sensitivity of blood culture, our findings indicate that there is still considerable value in performing blood culture for individuals reporting antibiotic use.


Subject:
[+]
AcademicSubjects/MED00290
Anti-Bacterial Agents
Antimicrobial Resistance
Bangladesh
Blood Culture
Enteric Fever
Hospitals
Humans
Nepal
Pakistan
Prospective Studies
Reproducibility Of Results
Salmonella Typhi
Supplement Articles
Typhoid
Typhoid Fever

Source:
Clin Infect Dis. 2020; 71(Suppl 3):S285-S292
Pubmed ID:
33258935
Pubmed Central ID:
PMC7705873
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:f0fc85c37ab87b464a7fafe51ad07749e55d72e187b2d54724dc5aa432e55242
File Type:

Supporting Files

• 	ciaa1333.nxml	xml
  	ciaa1333_fig1.gif	gif
  	ciaa1333_fig1.jpg	jpeg
  	ciaa1333_fig2.gif	gif
  	ciaa1333_fig2.jpg	jpeg

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