USEFULNESS OF BLOOD CULTURES IN PYELONEPHRITIS

To evaluate the usefulness of blood cultures in patients admitted with pyelonephritis, a retrospective chart review was conducted of inpatie nts at a 594-bed urban, academic medical center from 1990 through 1992 with a primary discharge diagnosis of pyelonephritis. A total of 338 patients had this primary discharge diagnosis. One or more sets of blo od cultures were obtained in 307 patients (91%), Fifty-six (18%) patie nts had a positive blood culture; 24 (32%) positive blood cultures gre w coagulase negative Staphylococcus species, in all but two instances considered a skin contaminant, Of the blood cultures drawn, only 1 (0. 2%) grew a pathogenic organism not found in the urine culture, with no impact on clinical management, These results support the conclusion t hat blood cultures are rarely clinically useful and seldom vary from u rine culture results. Potential annual cost savings of between $10 mil lion and $20 million in the United States could result from eliminatin g routine blood cultures in the setting of uncomplicated acute pyelone phritis. Copyright (C) 1997 by W.B. Saunders Company.