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September 9, 1992

Rapid Classification of Positive Blood Cultures

Author Affiliations

University of Minnesota Minneapolis

JAMA. 1992;268(10):1266. doi:10.1001/jama.1992.03490100060019

To the Editor.  —The authors of a recent study1 evaluating the interpretation of positive blood cultures are to be commended for publicizing the unglamorous but important truth that infectious disease specialists commonly categorize positive blood cultures as reflecting true bacteremia as opposed to contamination, based on a few simple clinical and laboratory parameters. Whether it was really necessary to perform complex statistical analyses on an extensive data set to reach the study's conclusions is arguable, since the same conclusions probably could have been arrived at equally well through brief conversations with the participating infectious diseases specialists.The important point is that infectious disease specialists do indeed use time to culture positivity, number of cultures positive, organism type, and the pretest clinical likelihood of bacteremia to assess the validity of a positive blood culture. Infection at a different site caused by the same organism is also an important consideration; this