Concordance between blood and cerebrospinal fluid cultures in meningitis.

OBJECTIVE: To examine the association between cerebrospinal fluid (CSF) cultures and blood cultures in patients with suspected bacterial or fungal meningitis. METHODS: A 5-year retrospective chart review, conducted from April 2012 to January 2017 of consecutive patient encounters with bacterial or fungal organism growth in CSF culture, when a blood culture was also obtained. Patients were excluded if they received antibiotics prior to either lumbar puncture (LP) or blood culture acquisition, or if CSF cultures were positive for common bacterial skin contaminants. Descriptive statistics were used to characterize the dataset. RESULTS: 21 patient encounters met study inclusion criteria. 13 (61.9%; 95% CI 40.2-80.5%) had blood culture growth of the same organism as the CSF culture. 1 patient had a different organism in the blood culture compared to the CSF culture. 6 patients (33.3%, 95% CI 14.8%-56.9%) with positive CSF cultures had negative blood cultures. CONCLUSIONS: Our results suggest an insufficient degree of agreement between CSF and blood culture results. PCR may be a prudent approach in patients requiring immediate antibiotics and delayed LP.

Improvement in likelihood to donate blood after being offered a topical anesthetic.

BACKGROUND: While there are many reasons people choose not to donate blood, pain sustained during the venipuncture portion of the blood donation process is likely one deterrent to volunteer donation. The purpose of this study was to survey the improvement in likelihood of donation if participants were given the option of a topical anesthetic cream prior to venipuncture. STUDY DESIGN AND METHODS: Over a three month period 316 adults (convenience sample) completed a one page survey consisting of twelve questions pertaining to blood donation. Participants were asked about their likelihood of donating blood in the near future (No Possibility, Possible, Likely, Certain). They were then informed of the possibility of using a topical anesthetic cream prior to donation. Subsequently, their likelihood of donating blood was reassessed. RESULTS: Fifty (16%) subjects reported an increased likelihood of donating blood if offered a topical anesthetic (p〈0.0001). Of these respondents reporting an increase in donation likelihood, eleven improved by 2 or more likelihood categories. Amongst the 169 participants who never donated blood, 34 (20%) reported an increased likelihood of donation after being told about the topical anesthetic cream, compared to 16 (10%) of the 147 subjects who had previously donated blood (p=0.02). CONCLUSION: The findings of this study suggest that providing a topical anesthetic had a positive effect on the study participants' likelihood of donating blood. This improvement was greater amongst those who have never donated blood.