Clinical correlations of serial quantitative blood cultures determined by lysis-centrifugation in patients with persistent septicemia

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Abstract
The potential clinical value of colony counts determined by the lysis-centrifugation blood culture method was studied by reviewing the records of 8 patients with persistent septicemia in whom colony counts were available on at least 3 days. Colony counts of the 5 patients who survived decreased steadily as the patients improved. Of the 3 patients who died, 1 had counts repeatedly < 1.0 CFU[colony-forming units]/ml while she was clinically stable and higher counts when her condition deteriorated. Two patients died despite decreasing colony counts. One was improving and died unexpectedly of an unrelated cause; the other died of candidiasis, but declining serial arabinitol/creatinine ratios suggested a partial response to therapy. Septicemia related to infected i.v. catheters was documented by demonstrating large differences in colony counts determined simultaneously from 2 different sites in 2 patients and by demonstrating a precipitous drop in CFU per milliliter after removal of the infected catheter in 1 patient. Routine availability of colony counts appears to be an important advantage of the lysis-centrifugation method.