What is the role of bacterial cultures in the workup of bacterial sepsis?

Updated: Feb 05, 2019
  • Author: Amber Mahmood Bokhari, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Obtain blood cultures in all patients upon admission. Negative blood culture results are also necessary to include pseudosepsis in the differential diagnosis. [42] Blood culture isolates might suggest the underlying disease process. Bacteroides fragilis suggests a colonic or pelvic source, whereas Klebsiella species or enterococci suggest a gallbladder or urinary tract source.

If central intravenous (IV) line sepsis is suspected, remove the line and send the tip for semiquantitative bacterial culture. If culture of the catheter tip yields positive results and demonstrates 15 or more colonies and if the isolate from the tip matches the isolate from the blood culture, an infection associated with the central IV line is diagnosed.

ICU patients are at a greater risk of colonization by MRSA, vancomycin-resistant enterococci (VRE), and carbapenem-resistant Enterobacteriaceae (CRE). It is critical to deescalate or change the empiric antibiotic regimen once the organism susceptibilities are available.

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