The development of metastatic infection (endocarditis, vasculitis, spondylodiscitis, or pulmonary abscess) is a major complication of gram-positive bacteremia. Early detection of metastatic infection has critical importance.
(4) reported a sensitivity of 100%, a specificity of 87%, and a negative predictive value of 89% for F-18 FDG PET/CT imaging in the detection of metastatic infections in patients with gram-positive bacteremia (3).
(19) The reduction in the use of the central venous catheter and the reduced presence of severe mucositis may have contributed to a decreasing in Gram-positive bacteremia. In addition, isolation of Gram (+) or Gram (-) bacteria from culture studies seemed to exert a significant impact on the rate of mortality in FEN patients with hematological malignancies.
Prior studies have revealed that Gram-negative bacteremia in patients with neutropenic fever is usually associated with higher mortality rates than Gram-positive bacteremia. But the influence of bacteremia due to Gram-negative bacteria with and without antibiotic resistance on outcomes of hematological patients is controversially.
Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia
. Crit Care 2010; 14: R27.
Mortality following blood culture in premature infants: increased with Gramnegative bacteremia and candidemia, but not Gram-positive bacteremia
. J Perinatol 2004;24(3):175-80.
GN bacteremia was more prevalent than Gram-positive bacteremia. The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups.
We found that endotoxin level in GN bacteremia was higher than that in Gram-positive bacteremia, and in the GN bacteremia, non- Enterobacteriaceae had a significantly higher level of endotoxin than Enterobacteriaceae .
There are also reports of BG positivity in patients with bacteremia, with indications that BG levels appear higher with gram-negative than gram-positive bacteremia
. Some species of Streptococcus, Escherichia coli, and Pseudomonas have been shown to produce glucan or glucanlike polymers that could potentially interfere with the BG assay.
In total, 19 patients had blood culture-positive results; 6 had gram-positive bacteremia
and 13 had gram-negative bacteremia.