{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:41:14Z","timestamp":1790530874202,"version":"4.1.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Polymicrobial blood stream infection is often considered uncommon, and corresponding cultures may be assumed to represent contamination. Here we characterized the prevalence and epidemiology of these cultures submitted to a central clinical microbiology laboratory.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Blood cultures from 2017 to 2018 (n\u2009=\u2009104 547) were evaluated. Polymicrobial blood cultures were defined by the presence of more than one organism in a blood culture set (set\u2009=\u2009one aerobic and one anaerobic bottle). Data were stratified by patient location and characteristics of the microbiota detected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of all blood culture sets, 14\u2009600 (14.0%) were positive. Among these, 1651 sets (11.3% of positive cultures; 1.6% of total cultures) were polymicrobial. Most cultures (85.2%) grew two microorganisms; the greatest number of microorganisms in a culture was 6. The most common microorganism pairs were (a) two coagulase-negative staphylococci (CoNS), (b) Corynebacterium and CoNS, and (c) S. aureus and CoNS. Microorganisms in polymicrobial cultures represented microbiota from skin (46.1%), the gastrointestinal (GI) tract (33.9%), strict anaerobes (1.4%), and \u201cother\u201d microorganisms (18.6%). Most cultures with GI microbiota originated from an adult academic medical center compared to community or pediatric settings (40.5% of polymicrobial cultures vs 27.2% and 25.8%, P\u2009&amp;lt;\u20090.0001). Within the academic medical center, patients in an intensive care unit (ICU) or who had bone marrow transplants (BMT) had more cultures suggestive of GI microbiota compared to those from the emergency department (ED) (50.8% and 52.8% vs 31.2%, P\u2009&amp;lt;\u20090.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Polymicrobial blood cultures are common in a variety of healthcare settings and the recovered microorganisms can be clinically relevant.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfab052","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T12:10:56Z","timestamp":1620389456000},"page":"1433-1440","source":"Crossref","is-referenced-by-count":6,"title":["More than Just Contaminants: Frequency and Characterization of Polymicrobial Blood Cultures from a Central Clinical Microbiology Laboratory Serving a Large Healthcare System"],"prefix":"10.1093","volume":"6","author":[{"given":"Kaitlin F","family":"Mitchell","sequence":"first","affiliation":[{"name":"Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie L","family":"Yarbrough","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey-Ann D","family":"Burnham","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"2021110213154494800_jfab052-B1","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1128\/CMR.00062-05","article-title":"Updated review of blood culture contamination","volume":"19","author":"Hall","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"2021110213154494800_jfab052-B2","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1086\/518873","article-title":"Polymicrobial infection in patients with cancer: an underappreciated and underreported entity","volume":"45","author":"Rolston","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2021110213154494800_jfab052-B3","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1111\/j.1553-2712.2010.00871.x","article-title":"Characteristics and outcomes of polymicrobial bloodstream infections in the emergency department: a matched case\u2013control study","volume":"17","author":"Lin","year":"2010","journal-title":"Acad Emerg Med"},{"key":"2021110213154494800_jfab052-B4","volume-title":"Best practices in blood cultures","year":"2018"},{"key":"2021110213154494800_jfab052-B5"},{"key":"2021110213154494800_jfab052-B6"},{"key":"2021110213154494800_jfab052-B7"},{"key":"2021110213154494800_jfab052-B8","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1128\/JCM.00581-15","article-title":"Identification of gram-negative bacteria and genetic resistance determinants from positive blood culture broths by use of the Verigene gram-negative blood culture multiplex microarray-based molecular assay","volume":"53","author":"Ledeboer","year":"2015","journal-title":"J Clin Microbiol"},{"key":"2021110213154494800_jfab052-B9","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1007\/s10096-019-03654-4","article-title":"Comparison of rapid BACpro\u00ae II, Sepsityper\u00ae kit and in-house preparation methods for direct identification of bacteria from blood cultures by MALDI-TOF MS with and without Sepsityper\u00ae module analysis","volume":"38","author":"Kayin","year":"2019","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2021110213154494800_jfab052-B10","article-title":"Multicenter evaluation of the accelerate PhenoTest BC Kit for rapid identification and phenotypic antimicrobial susceptibility testing using morphokinetic cellular analysis","volume":"2018;56:e01329-17.","author":"Pancholi","journal-title":"J Clin Microbiol"},{"key":"2021110213154494800_jfab052-B11","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1373\/jalm.2018.027201","article-title":"Clinical effect of expedited pathogen identification and susceptibility testing for gram-negative bacteremia and candidemia by use of the Accelerate PhenoTM System","volume":"3","author":"Burnham","year":"2019","journal-title":"J Appl Lab 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bloodstream infections in neutropenic patients via high throughput sequencing","volume":"10","author":"Gyarmati","year":"2015","journal-title":"PLoS ONE"},{"key":"2021110213154494800_jfab052-B16","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/acem.12057","article-title":"Reducing blood culture contamination in the emergency department: an interrupted time series quality improvement study","volume":"20","author":"Self","year":"2013","journal-title":"Acad Emerg Med"},{"key":"2021110213154494800_jfab052-B17","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1128\/JCM.02919-15","article-title":"Diagnosis of bloodstream infections in children","volume":"54","author":"Dien Bard","year":"2016","journal-title":"J Clin Microbiol"},{"key":"2021110213154494800_jfab052-B18","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciaa649","article-title":"Clinical impact of accelerate PhenoTM rapid blood culture detection system in bacteremic 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