Washington J A
Department of Microbiology, Cleveland Clinic Foundation, Ohio 44106.
J Antimicrob Chemother. 1987 Sep;20 Suppl A:29-39. doi: 10.1093/jac/20.suppl_a.29.
Variables affecting the isolation of microorganisms causing endocarditis include the volume of blood cultured, the number of blood cultures obtained, prior antimicrobial therapy, the type of microorganism involved, and blood culture technique. Culture-negative infective endocarditis is most frequently associated with prior antimicrobial therapy and nonbacterial agents, such as fungi, chlamydiae, and rickettsiae. For the diagnosis of bacterial endocarditis, culture of two to three separately collected blood samples of at least 10 ml, and preferably 20 ml, each generally suffices; however, in cases who have recently received antibiotics it may be necessary to culture an additional two to three blood samples or to consider use of beta-lactamase, antimicrobial adsorbent resins, or lysis-concentration, the last of which is also the most effective method for recovering mycobacteria and fungi from blood.
影响引起心内膜炎的微生物分离的变量包括血培养的体积、采集的血培养数量、先前的抗菌治疗、所涉及的微生物类型以及血培养技术。培养阴性感染性心内膜炎最常与先前的抗菌治疗和非细菌病原体（如真菌、衣原体和立克次体）相关。对于细菌性心内膜炎的诊断，通常采集两到三份分别收集的至少10ml（最好为20ml）的血样进行培养就足够了；然而，对于近期接受过抗生素治疗的病例，可能需要额外培养两到三份血样，或者考虑使用β-内酰胺酶、抗菌吸附树脂或裂解浓缩法，其中最后一种也是从血液中分离分枝杆菌和真菌最有效的方法。
