Usefulness of blood cultures in the management of febrile patients in long-term care facilities.

The aims of the study presented here were to identify the risk factors associated with bacteremia in a long-term-care facility and to evaluate the role of blood cultures in the management of elderly patients with sepsis. All blood cultures performed during a 2-year period (3,177 from 1,588 patients) were screened, and 252 (15.8%) of them grew a pathogen. The first 100 bacteremic patients identified were enrolled in the study together with a control group of 100 non-bacteremic patients matched by sex, age and functional status. Chronic renal failure, urinary tract infection, severe sepsis, leukocytosis, eosinopenia and thrombocytopenia were identified as risk factors associated with bacteremia. Five bacteremic patients died during the first 48 h following the onset of infection, while all of the non-bacteremic patients survived this time period. Of 58 bacteremic patients receiving adequate treatment, 17 patients died, and of 39 receiving inadequate treatment, 12 patients died. These results indicate the usefulness of performing blood cultures in elderly patients with sepsis is questionable.