Journal of General and Family Medicine最新文献

{"title":"Improving outcomes of type 2 diabetes mellitus patients in primary care with Chronic Care Model: A narrative review","authors":"Arwa Ahmed Al-Qahtani MD","doi":"10.1002/jgf2.659","DOIUrl":"10.1002/jgf2.659","url":null,"abstract":"<p>Designed and implemented over two decades ago, the Chronic Care Model is a well-established chronic disease management framework that has steered several healthcare systems in successfully improving the clinical outcomes of patients with type 2 diabetes mellitus. Research evidence cements the role of the Chronic Care Model (with its six key elements of organization of healthcare delivery system, self-management support, decision support, delivery system design, clinical information systems, and community resources and policies) as an integrated framework to revamp the type 2 diabetes mellitus-related clinical practice and care that betters the patient care and clinical outcomes. The current review is an evidence-lit summary of importance of use of Chronic Care Model in primary care and their impact on clinical outcomes for patients afflicted with one of the most debilitating metabolic diseases, type 2 diabetes mellitus.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"171-178"},"PeriodicalIF":1.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for encounters, diagnoses, and admission rate among emergency referrals at an urban primary care clinic in Japan: A retrospective cohort study","authors":"Yoshinao Satoi MD,&nbsp;Masato Matsushima MD, MPH, PhD,&nbsp;Hiroyoshi Iwata MD, PhD","doi":"10.1002/jgf2.704","DOIUrl":"10.1002/jgf2.704","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Comprehensive understanding of emergency referrals (EmR), encompassing reasons for encounters (RFEs) and diagnoses, is crucial for primary care physicians (PCPs). Comparing EmR rates and subsequent admission rates can potentially enhance the quality of primary care for EmR practice. However, no study has evaluated RFEs among patients with EmRs. This study aimed to identify RFE/diagnosis in relation to subsequent admission among patients receiving EmR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study at an urban family physician teaching clinic in Kawasaki City, Japan. Our cohort recruited consecutive EmR episodes with their medical records and admissions confirmed through response letters from receiving hospitals. Using the 2nd edition of the International Classification of Primary Care, we explored the frequency of RFEs and diagnoses, calculating EmR rates and admission rates as primary outcomes. Bivariate analyses were employed to compare admission and non-admission cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The present study encompassed 162 EmR episodes out of 47,901 visits, yielding an EmR rate of 3.38/1000 visits. Among 153 completely followed episodes, 99 patients were emergently admitted, resulting in a 64.7% admission rate. The admission group exhibited significantly higher age and a greater prevalence of dementia. Descriptive analysis revealed fever and pneumonia as the most frequent RFE and diagnosis, respectively, with significant differences between admission and non-admission groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study reports EmR and admission rates following EmR, highlighting differences in patient characteristics, RFEs, and diagnoses. The findings offer insights to enhance PCPs' EmR practices and serve as a benchmark for the scope of EmR practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"256-266"},"PeriodicalIF":1.8,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140966802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A large increase in Group A streptococcus bacteremia in the 2 month short period in 2024; report from a tertiary care hospital in Chiba, Japan","authors":"Kanta Kurasawa MD,&nbsp;Misato Yoshida MD,&nbsp;Masahiko Nakao MD,&nbsp;Emiri Muranaka MD,&nbsp;Yushi Hachisu DVM,&nbsp;Mitsuru Kishizawa,&nbsp;Takashi Kikuchi DVM,&nbsp;Ryota Hase MD","doi":"10.1002/jgf2.702","DOIUrl":"10.1002/jgf2.702","url":null,"abstract":"&lt;p&gt;Following the COVID-19 pandemic, several European countries and the United States reported a marked increase in scarlet fever and invasive Group A streptococcus (GAS) infection.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Although this trend is likely because of reduced exposure and the immunity gap associated with a strict mask policy or social distancing during the pandemic, it is also thought to be related to the emergence and spread of the more toxigenic M1 UK variant.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; In Japan, an increasing number of cases of streptococcal toxic shock syndrome (STSS) caused by GAS have been reported since July 2023.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In the first 2 months of 2024, a large increase in GAS bacteremia was detected at the Japanese Red Cross Narita Hospital, a tertiary teaching hospital with 710 beds. A total of six cases of bacteremia (2.37906 cases/1000 hospital admissions) were detected during the 2 months (Table 1). The median age was 45 years (range: 34–75 years). No patient was severely immunocompromised. The most common focus of infection was pneumonia with empyema (n = 3). The median Pitt bacteremia score and SOFA score were 2 and 3.5, respectively. Among six isolates from these cases, five were serotype T1 and positive for allele-specific PCR for the M1UK lineage.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Two patients died within the first day of hospitalization, and most of the surviving patients required surgical intervention. Given this increase, we analyzed the distribution of cases of GAS bacteremia during 2016–2023. The average number of cases of GAS bacteremia per year was 3.25 cases during 2016–2019 (0.21125 cases/1000 hospital admissions) and 1.75 cases during 2020–2023 (0.11654/1000 hospital admissions), respectively.&lt;/p&gt;&lt;p&gt;Circulation of the M1&lt;sub&gt;UK&lt;/sub&gt; variant strain may have contributed to the large increase in STSS cases in Japan. Previous reports have suggested that the M1&lt;sub&gt;UK&lt;/sub&gt; lineage may drive the observed increase in GAS infections in Europe.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; In Japan, the M1&lt;sub&gt;UK&lt;/sub&gt; strains account for only 6.4% of all 780 strains collected at eight reference centers during 2018–2023, but nine out of 19 strains were found to be the M1&lt;sub&gt;UK&lt;/sub&gt; strains in reported STSS cases since August 2023 in the Kanto region.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The incidence of GAS bacteremia in our hospital during the 2 month short period in 2024 was much higher than that before and during the COVID-19 pandemic, and most cases were caused by the M1&lt;sub&gt;UK&lt;/sub&gt; variant strain, which is consistent with the trend in the surveillance data shown above.&lt;/p&gt;&lt;p&gt;In conclusion, this report suggests that the M1&lt;sub&gt;UK&lt;/sub&gt; variant has been spread in certain areas in Japan and is likely to contribute to the large increase in invasive GAS infections.&lt;/p&gt;&lt;p&gt;Physicians should be cautious about this significant increase.&lt;/p&gt;&lt;p&gt;None.&lt;/p&gt;&lt;p&gt;The authors report that there are no competing interests to disclose.&lt;/p&gt;&lt;p&gt;This study was approve","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"289-290"},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140990817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic cerebrospinal fluid leak can cause amyotrophic lateral sclerosis mimic","authors":"Satoshi Saito MD,&nbsp;Ryotaro Ikeguchi MD, PhD,&nbsp;Kazuo Kitagawa MD, PhD","doi":"10.1002/jgf2.691","DOIUrl":"10.1002/jgf2.691","url":null,"abstract":"<p>Chronic cerebrospinal fluid leak with spinal cord compression can mimic the symptoms of ALS, with a snake-eyes appearance on MRI.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"237-238"},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.691","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relation between resident mentorship and in-training examination scores: A nation-wide, cross-sectional study in Japan","authors":"Kohta Katayama MD, PhD,&nbsp;Yuji Nishizaki MD, MPH, PhD,&nbsp;Toshihiko Takada MD, MPH, MSc, PhD,&nbsp;Koshi Kataoka MMSc,&nbsp;Nathan Houchens MD,&nbsp;Taro Shimizu MD, PhD, MSc, MPH, MBA,&nbsp;Yu Yamamoto MD,&nbsp;Takashi Watari MD, MHQS, MCTM, PhD,&nbsp;Yasuharu Tokuda MD, MPH,&nbsp;Yoshiyuki Ohira MD, PhD","doi":"10.1002/jgf2.703","DOIUrl":"10.1002/jgf2.703","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mentorship is a dynamic reciprocal relationship, wherein a novice (mentee) grows with the encouragement of an advanced careerist (mentor). It is widely implemented in medical training programs. However, there are few reports on mentorship's educational effects in the Japanese context. This study investigated the association between mentorship and in-training examination scores during a clinical residency program in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in Japan, involving first and second year postgraduate (PGY-1 and PGY-2) residents set to take the General Medicine In-Training Examination (GM-ITE) at the end of the academic year of 2021. The GM-ITE, developed by a non-profit organization in 2012, assesses the overall clinical knowledge of PGY-1 and PGY-2 residents. Data on mentorship were obtained through an electronic survey, conducted immediately after the GM-ITE. The association between a resident's self-reported identification of at least one mentor and GM-ITE score was analyzed at multiple levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the total 4929 residents, 3266 (66.3%) reported having mentors. However, there was no association between mentorship and GM-ITE scores (adjusted score difference [aSD] = −0.22; 95% confidence interval [95% CI]: −0.64 to 0.19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among Japanese residents, in-training examination scores were not associated with mentorship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"249-255"},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140992812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal, health system, and geosocial disparities in appointment nonadherence at family medicine clinics in southcentral Pennsylvania, United States","authors":"Wen-Jan Tuan DHA, MS, MPH,&nbsp;Ashley Weems,&nbsp;Shou Ling Leong MD","doi":"10.1002/jgf2.698","DOIUrl":"10.1002/jgf2.698","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To assess the relationship between patients' demographic, health system-related, and geosocial characteristics and the risk of missed appointments among patients in family medicine practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was based on a retrospective cross-sectional design using electronic health records and neighborhood-level social determents of health metrics linked by geocoded patients' home address. The study population consisted of patients who had a primary care provider and at least one appointment at 14 family medicine clinics in rural and suburban areas in January–December 2022. Negative binomial regression was utilized to examine the impact of personal, health system, and geosocial effects on the risk of no-shows and same-day cancellations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 258,614 appointments were made from 75,182 patients during the study period, including 7.8% no-show appointments from 20,256 patients. The analysis revealed that individuals in the ethnic minority groups were 1.24–1.65 times more likely to miss their appointments than their White counterpart. Females and English speakers had 14% lower risk for no-show. A significant increase (32%–64%) in the odds of no-shows was found among individuals on Medicaid and uninsured. Persons with prior history of no-shows or same day cancellations were 6%–27% more likely to miss their appointments. The no-show risk was also higher among people living in areas experiencing socioeconomic disadvantage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The risk of missed appointments is affected by personal, health system, and geosocial contexts. Future efforts aiming to reduce no-shows could develop personalized interventions targeting the at-risk populations identified in the analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"214-223"},"PeriodicalIF":1.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141009165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scalp vein sign caused by intracranial dural arteriovenous fistula","authors":"Munenori Iwamoto MD,&nbsp;Yoshihisa Otsuka MD, PhD,&nbsp;Tsuneaki Kenzaka MD, PhD,&nbsp;Masaaki Kohta MD, PhD,&nbsp;Yusuke Okamura MD, PhD","doi":"10.1002/jgf2.701","DOIUrl":"10.1002/jgf2.701","url":null,"abstract":"<p>A 68-year-old man presented with a headache that had started 1 month earlier. The scalp vein dilatation was observed at presentation. The findings of computed tomography and magnetic resonance imaging raised suspicion of a dural arteriovenous fistula, leading to the definitive diagnosis by digital subtraction angiography. Scalp vein signs can be a useful clue to suspect intracranial abnormalities, including dural arteriovenous fistula.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"239-240"},"PeriodicalIF":1.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Japanese primary care physicians' postpartum mental health care: A cross-sectional study","authors":"Keiichiro Narumoto MD, MPH, PhD,&nbsp;Miho Endo MD,&nbsp;Makoto Kaneko MD, MClSc, PhD,&nbsp;Tomoko Iwata MD,&nbsp;Machiko Inoue MD, MPH, PhD","doi":"10.1002/jgf2.700","DOIUrl":"10.1002/jgf2.700","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postpartum mental health care is a public health priority requiring interprofessional and interorganizational collaboration. Primary care physicians (PCPs) have the potential to play an essential role in facilitating access to health care and providing comprehensive and coordinated care for postpartum mental health problems. In Japan, however, there are no previous studies on the extent to which PCPs are involved in postpartum mental health care. Therefore, this study aimed to investigate the practices and experiences of Japanese PCPs in providing such care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study presents a subset of the findings from a cross-sectional study using an online questionnaire on postpartum care among Japanese PCPs. We employed descriptive analysis to examine their practices and experiences in providing general and postpartum mental health care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We received 339 valid responses from 5811 PCPs. The median proportion of the outpatients with mental health problems that PCPs regularly saw was 15%. Approximately two out of three PCPs (68.7%) reported routinely performing screening for depression and anxiety. Seventy-six percent of PCPs had the opportunity to provide care for postpartum women. Approximately one in two PCPs (47.8%) had managed cases of postpartum mental health problems and collaborated with various professionals and resources to provide care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The majority of Japanese PCP participants in the study provide mental health care and have managed cases of postpartum mental health problems, collaborating with various health professionals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"224-231"},"PeriodicalIF":1.8,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.700","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of a Morbihan's disease patient after a therapeutic challenge: A case report and comprehensive literature review","authors":"Afsaneh Sadeghzadeh Bazargan MD,&nbsp;Ali Zare Dehnavi MD,&nbsp;Abbas Dehghani MD,&nbsp;Kambiz Kamyab Hesari MD,&nbsp;Paria Jafari MD,&nbsp;Azadeh Goodarzi MD","doi":"10.1002/jgf2.690","DOIUrl":"10.1002/jgf2.690","url":null,"abstract":"<p>Morbihan's disease is a rare condition characterized by chronic facial edema. While its exact cause is unknown, it is thought to involve local cutaneous vascularization and lymphatic drainage imbalance. Traditional treatment options are often ineffective, and no established efficient treatment exists. We present a case study of a 17-year-old male with Morbihan's syndrome who showed resistance to traditional treatments but responded well to a combination of cromolyn sodium nasal spray and oral montelukast after histopathology revealed hyperplasia of plasma cells and mast cells. This combination has not been used before for Morbihan's syndrome. Our review of the literature also provides insight for clinicians seeking to manage this condition.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"232-236"},"PeriodicalIF":1.8,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141021354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing and prediction of secondary bacteremia in patients with COVID-19: A retrospective cohort study","authors":"Aoi Yogo,&nbsp;Shungo Yamamoto MD, DTM&H, DrPH,&nbsp;Kentaro Tochitani","doi":"10.1002/jgf2.697","DOIUrl":"10.1002/jgf2.697","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to aid the appropriate use of antimicrobial agents by determining the timing of secondary bacteremia and validating and updating clinical prediction models for bacteremia in patients with COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study on all hospitalized patients diagnosed with COVID-19 who underwent blood culture tests from January 1, 2020, and September 30, 2021, at an urban teaching hospital in Japan. The primary outcome measure was secondary bacteremia in patients with COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 507 patients hospitalized with COVID-19, 169 underwent blood culture tests. Eleven of them had secondary bacteremia. The majority of secondary bacteremia occurred on or later than the 9th day after symptom onset. Positive blood culture samples collected on day 9 or later after disease onset had an odds ratio of 22.4 (95% CI 2.76–181.2, <i>p</i> &lt; 0.001) compared with those collected less than 9 days after onset. The area under the receiver operating characteristic curve of the modified Shapiro rule combined with blood culture collection on or after the 9th day from onset was 0.919 (95% CI, 0.843–0.995), and the net benefit was high according to the decision curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The timings of symptom onset and hospital admission may be valuable indicators for making a clinical decision to perform blood cultures in patients hospitalized with COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"206-213"},"PeriodicalIF":1.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}