Bandemia as an Early Predictive Marker of Bacteremia: A Retrospective Cohort Study

Abstract

This single-center retrospective observational study aimed to verify whether a diagnosis of bandemia could be a predictive marker for bacteremia. We assessed 970 consecutive patients (median age 73 years; male 64.8%) who underwent two or more sets of blood cultures between April 2015 and March 2016 in both inpatient and outpatient settings. We assessed the value of bandemia (band count > 10%) and the percentage band count for predicting bacteremia using logistic regression models. Bandemia was detected in 151 cases (15.6%) and bacteremia was detected in 188 cases (19.4%). The incidence of bacteremia was significantly higher in cases with bandemia (52.3% vs. 13.3%; odds ratio (OR) = 7.15; 95% confidence interval (CI) 4.91–10.5). The sensitivity and specificity of bandemia for predicting bacteremia were 0.42 and 0.91, respectively. The bandemia was retained as an independent predictive factor for the multivariable logistic regression model (OR, 6.13; 95% CI, 4.02–9.40). Bandemia is useful for establishing the risk of bacteremia, regardless of the care setting (inpatient or outpatient), with a demonstrable relationship between increased risk and bacteremia. A bandemia-based electronic alert for blood-culture collection may contribute to the improved diagnosis of bacteremia.