A 58-year-old man with diabetes mellitus presents to the emergency department with fever (39.5°C), hypotension (BP 88/52 mmHg), tachycardia (HR 118/min), and altered mental status. He has a urinary catheter in situ for 3 days. Clinical suspicion for septic shock is high. Which investigation is most appropriate to identify the causative organism and guide antimicrobial therapy?

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