Frequency of Positive Blood Cultures and Pathogen Distribution among Febrile Patients Admitted to Northwest General Hospital, Peshawar
DOI:
https://doi.org/10.37762/jgmds.13-4.867Keywords:
Fever, Blood Culture, Bloodstream Infection, Bacteremia, Antimicrobial Stewardship, Enterobacteriaceae, MortalityAbstract
OBJECTIVES
To determine the frequency of positive blood cultures, describe the distribution of clinically significant pathogens, and compare selected clinical outcomes according to blood-culture status among febrile adult inpatients at Northwest General Hospital, Peshawar.
METHODOLOGY
This prospective observational cohort study enrolled 129 consecutive febrile patients aged 18-90 years admitted to the Department of General Medicine from January to June 2025. Two blood-culture sets were collected using aseptic technique and processed in an automated culture system. Positive bottles underwent Gram staining, subculture, and organism identification by matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. Patients were followed until discharge or in-hospital death. Data were analysed using SPSS version 25, with appropriate non-parametric and exact tests; p<0.05 was considered significant.
RESULTS
Blood cultures were positive in 50/129 patients (38.8%). Enterobacteriaceae accounted for 48.0% of positive cultures, Gram-positive cocci for 40.0%, and non-fermenting Gram-negative rods for 12.0%. Staphylococcus aureus was the most frequent species (22.0%). Carbapenems (31.0%) and cephalosporins (27.9%) were the most frequently prescribed antimicrobial classes. Culture-positive patients were less often male (48.0% vs 70.9%; p=0.015), had lower median diastolic blood pressure (70 vs 80 mmHg; p=0.004), and longer median hospital stay (4 vs 3 days; p=0.043). Mortality was higher among culture-positive patients (20.0% vs 10.1%), although not statistically significant(p=0.126).
CONCLUSION
Bloodstream infection was frequent among febrile inpatients, with substantial Gram-negative and Gram-positive pathogen burdens. The findings support timely blood-culture sampling, careful interpretation, and strengthened antimicrobial stewardship. Local surveillance of pathogen distribution and resistance should guide empiric therapy and institutional antibiotic prescribing in this hospital population.
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