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Objective: The aim of the study was to analyze predictive factors of bacteraemia in patients seen in the emergency department (ED) for an episode of infectious disease., Methods: Observational, retrospective and descriptive analytical study of all blood cultures extracted in an ED in adult patients (≥ 18 years) seen in ED due to infec-tious disease from 1-1-2019 to 1-7-2019. The follow-up was carried out during 30 days. Thirty-eight variables for predicting bacteraemia were assessed. They covered epidemiological, comorbidity, functional, clinical and analytical factors. Univariate and multivariate logistic regression analysis was performed., Results: A total of 1,425 blood cultures were finally enrolled in the study. Of those were considered true bacteremia 179 (12.6 %) and as negative blood cultures 1,246 (87.4 %). Amongst negatives, 1,130 (79.3%) without growth and 116 (8.1%) as contaminants blood cultures. Five variables were significantly associated with true bacteraemia: serum procalcitonin (PCT) ≥ 0.51 ng/ml [odds ratio (OR): 4.52; 95% confidence interval (CI): 4.20-4.84, P <.001], temperature > 38.3°C [OR:1.60; 95% CI:1.29-1.90, P <.001], systolic blood pressure (SBP) < 100 mmHg [OR:3.68; 95% CI:2.78-4.58, P <.001], septic shock [OR:2.96; 95% CI:1.78-4.13, P <.001] and malignancy [OR:1.73; 95% CI:1.27-2.20, P <.001]., Conclusions: Several factors evaluated in an initial assessment in the ED, including serum PCT, temperature, hypotension (with/without septic shock) and being malignancy, were found to predict true bacteraemia., (©The Author 2020. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Objectives: To analyse and compare the ability of procalcitonin (PCT), C-reactive protein (CRP) and leukocytes to differentiate true bacteraemia from contaminated blood cultures in patients seen in the emergency department (ED) for an episode of infectious disease., Methods: Observational, retrospective and descriptive analytical study of all blood cultures with positive growth extracted in an ED in adult patients (≥18 years) during 2016 and 2017. The follow-up was carried out over a 30-day period to calculate the predictive power and the prognostic performance for true bacteraemia., Results: A total of 266 blood cultures with positive growth were included in the study. Out of these, 154 (57.9%) were considered true bacteraemia and 112 (42.1%) were considered to be contaminated blood cultures. The area under the Receiver Operating Characteristic curve (AUC-ROC) for PCT to predict true bacteraemia was 0.983 (95% CI: 0.972-0.994; P<0.001) and, considering a cut-off value of≥0.43 ng/ml, PCT achieved 94% sensitivity, 91% specificity, positive predictive value of 94%, and negative predictive value of 92%. The AUC-ROC obtained for CRP was 0.639 (95% CI: 0.572-0.707, P<.001), for leukocytes of 0.693 (95% CI: 0.630-0.756, P<.001) and for immature leukocytes (>10% bands) of 0.614 (95% CI: 0.547-0.682, P<.001). The mean values for PCT were 3.44 (SD 6.30) ng/ml in true bacteraemia vs. 0.16 (SD 0.18) ng/ml in contaminated blood cultures (P<.001)., Conclusions: In blood cultures with positive growth extracted in an ED, PCT achieves the best prognostic performance of true bacteraemia vs. contaminated blood cultures, better than CRP and leukocytes., (Copyright © 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)