Validation and prognostic utility of a definition of uncomplicated Gram-negative bloodstream infection

The standardization of Gram-negative bloodstream infection (GN-BSI) management is challenging ( 1 Thaden J.T. Tamma P.D. Pan Q. Doi Y. Daneman N. Survey of infectious diseases providers reveals variability in duration of antibiotic therapy for the treatment of Gram-negative bloodstream infections. JAC Antimicrob Resist. Marzo 2022; 4dlac005 Crossref Scopus (2) Google Scholar , 2 Gatti M. Bonazzetti C. Tazza B. Pascale R. Miani B. Malosso M. et al. Impact on clinical outcome of follow-up blood cultures and risk factors for persistent bacteraemia in patients with gram-negative bloodstream infections: a systematic review with meta-analysis. Clin Microbiol Infect. Settembre 2023; 29: 1150-1158 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar ). Heil and colleagues proposed a definition of uncomplicated GN-BSI (uGN-BSI) based on the host immune system status, the source of GN-BSI, the quality of source control and the clinical response ( 3 Heil E.L. Bork J.T. Abbo L.M. Barlam T.F. Cosgrove S.E. Davis A. et al. Optimizing the Management of Uncomplicated Gram-Negative Bloodstream Infections: Consensus Guidance Using a Modified Delphi Process. Open Forum Infect Dis. Ottobre 2021; 8ofab434 Crossref Scopus (33) Google Scholar ). The authors proposed that patients with uGN-BSI may not need follow-up blood cultures (FU-BCs) and can receive a short treatment duration. A real-life evaluation of this new definition is necessary before introducing it into clinical practice. We retrospectively analysed the prognostic utility of uGN-BSI definition in a cohort of adult patients with GN-BSI hospitalized at the IRCCS Azienda Ospedaliero-Universitaria of Bologna during 5-year period (see Supplementary Material). The study was approved by the local Ethics Committee (n° 894/2021/Oss/AOUBo).