The choice of antibiotic treatment was primarily guided by microbial findings; the majority of patients were treated with 4 8 weeks of i.v antibiotics, often followed by a period of peroral antibiotic treatment.
EBV DNA was often found together with other microbial findings in CSF of immunocompromised patients.
The initial empirical antibiotic treatment was effective in 45.8% of cases, inappropriate in 6.1%, and of uncertain appropriateness (because of a lack of microbial findings) in 46.7%.
Furthermore, we did not consider microbial test results, because it is difficult to differentiate between infective sources and indigenous bacteria, particularly in elderly subjects, and the sensitivity and specificity of microbial findings are low.
Although immunocompromised patients are more susceptible to a variety of infectious diseases, available resources and a concern that the clinical relevance of novel microbial findings would be more difficult to interpret in immunocompromised persons compelled us to focus on previously healthy persons.
Table with all microbial findings judged as clinically relevant or of unknown significance detected by blood culture and/or NAATs.
Some data show a good concordance between bacterial colonization of the airway and microbial findings in the biofilm [ 19].
All records of the patients and microbial findings were assessed by two senior physicians in infectious diseases (LL and GJ).
A significant microbial finding, e.g., single detection of a species with significant pathogenic profile or multiple detection of the same but low-pathogenic species, should alert the clinician independent of clinical signs of sepsis and whether the detection method was culture or molecular.
Additional file 1: All 77 episodes for which at least one microbial finding judged as clinically relevant or of unknown significance was detected with blood culture and/or NAATs.
