David Alonso Menchén, Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón. Calle Doctor Esquerdo 46, 28007 Madrid, Spain.
Rev Esp Quimioter. 2022 Dec;35(6):519-537. doi: 10.37201/req/066.2022. Epub 2022 Jul 28.
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.
菌血症是全球范围内发病率和死亡率的重要原因，尽管在过去几十年中取得了诊断和治疗方面的进展，但支持菌血症许多诊断方面的证据仍然不足。关于该实体的流行病学演变的信息有限，并且血液培养采集和分析的许多方法学方面仍在讨论中。此外，主要科学协会关于许多这些方面的建议存在差异，并且在许多情况下，最近没有更新。在这种情况下，我们就菌血症的不同方面安排了一系列问题，并查阅了文献，试图为这些问题找到合适的答案。我们对证据不足的主题发表了意见。涵盖的主题包括菌血症的流行病学方面、血液培养提取的指征、获取和培养样本的方法，或微生物学实验室结果的传输方式。我们不打算总结当前的临床实践指南，也不会处理该实体的治疗管理。本文的目的是通过批判性的方法回顾菌血症的诊断现状，指出文献中的空白，提供专门从事传染病和临床微生物学的团队的意见，并确定一些应关注未来研究的知识领域。
