A critical appraisal of the role of the clinical microbiology laboratory in the diagnosis of bloodstream infections

The detection of bloodstream infections is one of the most important functions of clinical microbiology laboratories. Despite advances in blood culture technology and clinical studies that have focused on the detection of bacteremia and fungemia, perfection has not been achieved and uncertainties persist. This review provides perspectives on a number of areas, including the recommended number of blood cultures, duration of incubation of blood cultures, use of anaerobic, in addition to aerobic, blood culture media, value of the lysis-centrifugation method, processing and reporting of probable blood culture contaminants, and limitations of current blood culture methods and systems. We also address the handling of blood cultures in point-of-care locations that lack full microbiology capabilities.