Emerging Technologies for Microbiologic Diagnosis of Sepsis: The Rapid Determination of Resistance to Antimicrobial Agents Should Be the Key
Jordi Rello, Carles Alonso-Tarrés
Abstract
(See the Major Article by Fida et al on pages 1165–72.) Blood cultures (BCs), aiming at the detection of viable microorganisms in blood, are currently considered the gold standard for microbiological diagnosis of bloodstream infections (BSIs) during sepsis [1]. However, this culture-based diagnosis suffers from important limitations, such as the long time to positivity (usually from 12 to 72 hours), the false-negative results due to ongoing antimicrobial therapy, the possible presence of fastidious or uncultivable pathogens or the inadequate volume of blood (especially in children), and the low number of circulating microorganisms (from 1 to 10 colony-forming units/mL), [2–4]. Therefore, its overall sensitivity is not optimal since the positivity of BCs can be as low as 30%–40% in sepsis [5]. It is important to emphasize that the major advantage of BCs is to allow the evaluation of antimicrobial susceptibility for pathogens. Pathogen detection will...