Blood cultures: Clinical aspects and controversies

During the past two decades, there have been important advances in blood cu lture methodology. These advances have resulted in earlier detection and id entification of pathogens causing bloodstream infections. However, there ar e many facets of the blood culture as a diagnostic test that are not affect ed by new culture methods or systems that continue to cause problems with i nterpretation of results. The objective of this review is to focus on those factors influencing the results of blood cultures that have clinical relev ance. Such factors include skin preparation, timing, procurement techniques , Volume of blood obtained, number of cultures, anaerobic blood cultures, a nd contamination. In addition, bacteremia prediction models are discussed a nd suggestions are provided as to how these models could be of greater clin ical use. Blood culture methods and systems are not discussed in this revie w.