Blood culture: gold standard for definitive diagnosis of bacterial and fungal infections--from the laboratory aspect
Yamane, N.
Rinsho Byori. Japanese Journal of Clinical Pathology 46(9): 887-892
1998
ISSN/ISBN: 0047-1860 PMID: 9800473 Document Number: 495141
Blood culture has been long recognized as a gold standard for definitive diagnosis of bacterial and fungal infections worldwide. However, due to the lack of this recognition, particularly among physicians, very few number of blood cultures have been tested in microbiology laboratories throughout Japan. Positive results from blood cultures would have a great impact on clinical decisions; initiation of antibiotic chemotherapy, change to effective chemotherapy, and more frequently, change to less expensive chemotherapy. The "Rules of Three"; nearly all instances of bacteremia will be recognized after the incubation of three blood cultures for three days, originally proposed by Young et al. is still applicable to the most clinical instances, and will increase the value of blood cultures. The key to assuring greater clinical impact from blood cultures is rapidity to detect positive by the laboratory. Several automated blood culture systems are now commercially available, and will enable us to detect positive cultures significantly earlier than before.