Hemocultivos: indicaciones e interpretación
- Callejas Díaz, A. 1
- Calderón Parra, J. 1
- Fernández Cruz, A. 1
- 1 Servicio de Medicina Interna. Hospital Universitario Puerta de Hierro. Majadahonda. Madrid. España Universidad Autónoma de Madrid. Madrid. España Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA). Majadahonda. Madrid. España
ISSN: 0304-5412
Year of publication: 2022
Issue Title: Enfermedades infecciosas (II)
Series: 13
Issue: 50
Pages: 2956-2959
Type: Article
More publications in: Medicine: Programa de Formación Médica Continuada Acreditado
Abstract
Blood cultures are a fundamental tool for the diagnosis of bacteremia. The main disadvantage of this diagnostic method is its low sensitivity, in part related to difficulty in predicting the presence of bacteremia based on clinical symptoms. Shivering and fever are the two symptoms that best predict bacteremia, but they are still not reliable. On the other hand, there is there is another problem with the specificity of blood cultures, fundamentally due to the possibility of sample contamination. Blood culture contamination can lead to erroneous interpretation, with the consequent initiation of unnecessary or prolonged treatments that expose patients to greater adverse effects and longer hospital stays. To avoid these problems, there are multiple strategies aimed at decreasing the probability of blood culture contamination and key factors in their interpretation in order not to confuse it with a true bacteremia.
Bibliographic References
- Fabre V, Sharara SL, Salinas AB, Carroll KC, Desai S, Cosgrove SE. Does this patient need blood cultures? A scoping review of in- dications for blood cultures in adult nonneutropenic inpatients. Clin Infect Dis. 2020;71(5):1339-47.
- Doern GV, Carroll KC, Diekema DJ, Garey KW, Rupp ME, Weinstein MP. Practical guidance for clinical microbiology laboratories: A comprehensive update on the problem of blood culture contamination and a discussion of methods for addressing the problem. Clin Microbiol Rev. 2019;33(1):e00009-19.
- Cheng MP, Stenstrom R, Paquette K, Stabler SN, Akhter M, Davidson AC, et al. Blood culture results before and after antimicrobial administration in patients with severe manifestations of sepsis: A diagnostic study. Ann Intern Med. 2019;171(8):547-54.
- Riedel S, Bourbeau P, Swartz B, Brecher S, Carroll KC, Stamper PD. Timing of specimen collection for blood cultures from febrile patients with bacteremia. J Clin Microbiol. 2008;46(4):1381-5.
- Guna Serrano MR, Larrosa Escartín N, Marín Arriaza M, Rodríguez Díaz JC. Microbiological diagnosis of bacteraemia and fun- gaemia: Blood cultures and molecular methods. Enferm Infecc Microbiol Clin (Engl Ed). 2019;37(5):335-40.
- Osaki S, Kikuchi K, Moritoki Y, Motegi C, Ohyatsu S, Nariyama T. Distinguishing coagulase-negative Staphylococcus bactere- mia from contamination using blood-culture positive bottle detection pattern and time to positivity. J Infect Chemother. 2020;26(7):672-5.