Cor Vasa 2025, 67(4):449-456 | DOI: 10.33678/cor.2025.083
(Blood sampling for culture and interpreting microbiological findings at suspicion of infective endocarditis)
- Klinika infekčních nemocí, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Bulovka, Praha, Česká republika
Blood culture, together with echocardiography, is the basic examination used in the diagnosis of infective endocarditis. The article summarizes the principles of correct blood sampling for culture, from the classic principles to the modern approach of a single collection of 40-60 ml of blood. The author explains under what conditions the modern concept is advantageous and when, on the contrary, it can be problematic. The article also describes the most common mistakes that doctors make when taking blood cultures and interpreting microbiological findings. The text is intended primarily for cardiologists but it can also be useful for physicians of other specialties.
Keywords: Automated blood culture systems, Bacteriemia, Blood culture, Infective endocarditis, Time-to-detection
Received: May 23, 2025; Revised: July 7, 2025; Accepted: July 28, 2025; Prepublished online: June 2, 2012; Published: October 6, 2025 Show citation
References
- Línková H, Marek D, Mates M, et al. Doporučený postup Evropské kardiologické společnosti pro léčbu endokarditidy 2023. Delgado V, Ajmone Marsan N, de Waha S, et al. Zkrácený překlad dokumentu vypracovaný Pracovní skupinou pro chlopenní a vrozené srdeční vady České kardiologické společnosti, Českou společností kardiovaskulární chirurgie ČLS JEP a Společností infekčního lékařství ČLS JEP. Cor Vasa 2024;66:112-168.
- Delgado V, Ajmone Marsan N, de Waha S, et al. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023;44:3948-4042.
Go to original source...
Go to PubMed...
- Lamy B, Dargère S, Arendrup MC, et al. How to Optimize the Use of Blood Cultures for the Diagnosis of Bloodstream Infections? A State-of-the Art. Front Microbiol 2016;7:697.
Go to original source...
Go to PubMed...
- Li J, Plorde JJ, Carlson LG. Effects of volume and periodicity on blood cultures. J Clin Microbiol 1994;32:2829-2831.
Go to original source...
Go to PubMed...
- Gyawali B, Ramakrishna K, Dhamoon AS. Sepsis: The evolution in definition, pathophysiology, and management. SAGE Open Med 2019;7:2050312119835043.
Go to original source...
Go to PubMed...
- Washington JA 2nd. Blood cultures: principles and techniques. Mayo Clin Proc 1975;50:91-98.
- Lamy B. Blood culture time-to-positivity: making use of the hidden information. Clin Microbiol Infect 2019;25:268-271.
Go to original source...
Go to PubMed...
- Puerta-Alcalde P, Cardozo C, Suárez-Lledó M, et al. Current time-to-positivity of blood cultures in febrile neutropenia: a tool to be used in stewardship de-escalation strategies. Clin Microbiol Infect 2019;25:447-453.
Go to original source...
Go to PubMed...
- Beneš J, Gabrielová A, Horová B, et al. Porovnání různých způsobů hemokultivačního vyšetření. Epidemiol Mikrobiol Imunol 1996;45:101-107.
- Lee A, Mirrett S, Reller LB, Weinstein MP. Detection of bloodstream infections in adults: how many blood cultures are needed? J Clin Microbiol 2007;45:3546-3548.
Go to original source...
Go to PubMed...
- Weinstein MP. Current blood culture methods and systems: clinical concepts, technology, and interpretation of results. Clin Infect Dis 1996;23:40-46.
Go to original source...
Go to PubMed...
- Arendrup M, Jensen IP, Justesen T. Diagnosing bacteremia at a Danish hospital using one early large blood volume for culture. Scand J Infect Dis 1996;28:609-614.
Go to original source...
Go to PubMed...
- Dargère S, Parienti JJ, Roupie E, et al. Unique blood culture for diagnosis of bloodstream infections in emergency departments: a prospective multicentre study. Clin Microbiol Infect 2014;20:O920-7.
Go to original source...
Go to PubMed...
- Yu D, Larsson A, Parke Å, et al. Single-Sampling Strategy vs. Multi-Sampling Strategy for Blood Cultures in Sepsis: A Prospective Non-inferiority Study. Front Microbiol 2020;11:1639.
Go to original source...
Go to PubMed...
- Ekwall-Larson A, Yu D, Dinnétz P, et al. Single-Site Sampling versus Multisite Sampling for Blood Cultures: a Retrospective Clinical Study. J Clin Microbiol 2022;60:e0193521.
Go to original source...
Go to PubMed...
- Goehringer F, Soudant M, Alauzet C, et al. Single- versus multiple-sampling strategy for blood cultures in the diagnosis of infective endocarditis: the prospective multicenter UniEndo study. Clin Infect Dis 2025 Apr 3:ciaf163. doi: 10.1093/cid/ciaf163. Online ahead of print.
Go to original source...
Go to PubMed...
- Dempsey C, Skoglund E, Muldrew KL, Garey KW. Economic health care costs of blood culture contamination: A systematic review. Am J Infect Control 2019;47:963-967.
Go to original source...
Go to PubMed...
- Beneš J, Baloun R, Džupová O. Endokarditidy 2007: Výsledky multicentrické studie o výskytu a vlastnostech infekční endokarditidy. Vnitř Lék 2011;57:147-154.
- Parthasarathy S, Shah S, Raja Sager A, et al. Staphylococcus lugdunensis: Review of Epidemiology, Complications, and Treatment. Cureus 2020;12:e8801.
Go to original source...
Go to PubMed...
- Petti CA, Stratton CW IV. Streptococcus anginosus Group. In: Bennett JE, Dolin R, Blaser MJ (eds.). Principles and Practice of Infectious Diseases. 9th ed. Elsevier, 2020:2521-2525.
- Chamat-Hedemand S, Dahl A, Østergaard L, et al. Prevalence of Infective Endocarditis in Streptococcal Bloodstream Infections Is Dependent on Streptococcal Species. Circulation 2020;142:720-730.
Go to original source...
Go to PubMed...
- Fournier PE, Gouriet F, Casalta JP, et al. Blood culture-negative endocarditis: Improving the diagnostic yield using new diagnostic tools. Medicine (Baltimore) 2017;96:e8392.
Go to original source...
Go to PubMed...
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.