Update on detection of bacteremia and fungemia

Abstract

The presence of microorganisms in a patient's blood is a critical determinant of the severity of the patient's illness. Equally important, the laboratory isolation and identification of a microorganism present in blood determine the etiologic agent of infection, especially when the site of infection is localized and difficult to access. This review addresses the pathophysiology and clinical characteristics of bacteremia, fungemia, and sepsis; diagnostic strategies and critical factors in the detection of positive blood cultures; characteristics of manual and instrument approaches to bacteremia detection; approaches for isolating specific microorganisms associated with positive blood cultures; and rapid methods for the identification of microorganisms in blood cultures.

Multicenter prospective study of procalcitonin as an indicator of sepsis

“…In addition, the sensitivity of blood culture is low. 1 For patients with a slight possibility of bacterial infection, physicians tend to prescribe antibiotics so as not to miss severe infections such as septicemia. A rapid and reliable test to rule out bacterial infections would thus be very useful for knowing the suitable indications for antibiotics, and this could also have an impact on both the length of hospital stay and total medical costs.…”

Usefulness of Procalcitonin Serum Level for the Diagnosis of Bacteremia

“…The role of bacteremia prediction models in the care of patients is still unclear [4]. Moreover, only 5-10% of blood cultures performed in hospitals grow microorganisms [5]. A rapid and reliable test to rule out bacteremia would thus help in decision making and could have an impact both on the length of stay and the costs.…”

Evaluation of the BD BACTEC FX blood volume monitoring system as a continuous quality improvement measure

“…The literature describes a decline of the time to positivity of true-positive bottles [22] and an increase in false-positives of overfilled bottles of up to 0.9 % [23,24]. Because of the excess of natural inhibiting factors present in blood, false-negative cultures are to be expected [25]. BD annihilates this issue by using a lytic anaerobic bottle, which increases the microbial recovery by releasing phagocytized microorganisms into the B:b mixture [26].…”

“…Overfilled bottles drawn from patients receiving antibiotic treatment also result in excess inhibition and, therefore, prolonged time to positivity or even false-negativity [25].…”