ABSTRACT
Bacteremia is an important cause of morbidity and mortality worldwide and, despite the diagnostic and therapeutic advances of the last decades, the evidence supporting many diagnostic aspects of bacteremia is scarce. Information on the epidemiological evolution of this entity is limited and many methodological aspects of blood culture collection and analysis are under discussion. Furthermore, the recommendations of the main scientific societies on many of these aspects are variable and, in many cases, have not been updated recently.In this scenario, we have arranged a series of questions on different aspects of bacteremia and reviewed the literature trying to find proper answers for them. We offer our opinion on the topics where the evidence was weak.The topics covered include epidemiological aspects of bacteremia, indications for blood culture extraction, methods for obtaining and incubating samples, or ways of transmitting results from the microbiology laboratory.We do not intend to summarize the current clinical practice guidelines, nor will we deal with the therapeutic management of this entity. The aim of this paper is to review the current perspective on the diagnosis of bacteremia with a critical approach, to point out the gaps in the literature, to offer the opinion of a team dedicated to infectious diseases and clinical microbiology, and to identify some areas of knowledge on which future studies should focus. (AU)
La bacteriemia es una causa importante de morbilidad y mortalidad en todo el mundo y, a pesar de los avances diagnósticos y terapéuticos de las últimas décadas, la evidencia que apoya muchos aspectos diagnósticos suele ser escasa. La información sobre la evolución epidemiológica de esta entidad es limitada y muchos aspectos metodológicos sobre la obtención y análisis de hemocultivos están en discusión. Además, las recomendaciones de las principales sociedades científicas sobre muchos de estos aspectos son variables y, en muchos casos, no se han actualizado recientemente.En este escenario, hemos preparado una serie de preguntas sobre diferentes aspectos de la bacteriemia y hemos revisado la literatura tratando de encontrar respuestas adecuadas para ellas. Ofrecemos nuestra opinión sobre los temas en los que la evidencia era débil.Los temas tratados incluyen los aspectos epidemiológicos de la bacteriemia, las indicaciones para la extracción de hemocultivos, los métodos de obtención e incubación de muestras o las formas de transmisión de los resultados desde el laboratorio de microbiología.No pretendemos resumir las guías de práctica clínica actuales, ni trataremos el manejo terapéutico de esta entidad. El objetivo de este trabajo es revisar la perspectiva actual sobre el diagnóstico de la bacteriemia con un enfoque crítico, señalar las carencias en la literatura, ofrecer la opinión de un equipo dedicado a las enfermedades infecciosas y a la microbiología clínica, e identificar algunas áreas de conocimiento en las que deberían centrarse futuros estudios. (AU)
Subject(s)
Humans , Bacteremia/diagnosis , Bacteremia/drug therapy , Bacteremia/epidemiology , Bacteremia/mortality , Blood CultureABSTRACT
Bacteremia is an important cause of morbidity and mortality worldwide and, despite the diagnostic and therapeutic advances of the last decades, the evidence supporting many diagnostic aspects of bacteremia is scarce. Information on the epidemiological evolution of this entity is limited and many methodological aspects of blood culture collection and analysis are under discussion. Furthermore, the recommendations of the main scientific societies on many of these aspects are variable and, in many cases, have not been updated recently. In this scenario, we have arranged a series of questions on different aspects of bacteremia and reviewed the literature trying to find proper answers for them. We offer our opinion on the topics where the evidence was weak. The topics covered include epidemiological aspects of bacteremia, indications for blood culture extraction, methods for obtaining and incubating samples, or ways of transmitting results from the microbiology laboratory. We do not intend to summarize the current clinical practice guidelines, nor will we deal with the therapeutic management of this entity. The aim of this paper is to review the current perspective on the diagnosis of bacteremia with a critical approach, to point out the gaps in the literature, to offer the opinion of a team dedicated to infectious diseases and clinical microbiology, and to identify some areas of knowledge on which future studies should focus.