CULTURES FROM THE BLOOD In SEPTICÆMIA, PNEUMONIA, MENINGITIS AND CHRONIC DISEASES

Abstract

Our conclusions from the literature and our own experiments may be summarized as follows: I. Blood for bacteriological examination during life should be taken directly from the veins and in considerable quantity. II. Resorption of toxines is the most important feature in cases of sepsis; pyogenie bacteria invade the general circulation in a rather small proportion even of severe eases, and, as a rule, late in the course of the disease. III. A general infection by the pnenmococcus can be demonstrated occasionally in the late stages of acute lobar pneumonia. IV. The value of blood cultures as a means of diagnosis in obscure cases of sepsis is limited by the fact that invasion of the blood by the specific organism cannot be demonstrated during life in the majority of cases. Positive cultures are very valuable; negative cultures do not exclude local septic infections. V. The detection of specific bacteria in the blood of cases of sepsis and of pneumonia gives a very unfavorable prognosis in most cases. VI. General terminal infections with pyogenic cocci occasionally occur as an immediate cause of death in chronic disease. Local infections processes play this part more frequently. VII. As far as our experiments have shown, invasion of the blood by bacteria during the death agony, with subsequent distribution of the genus to the organs by the circulation, is a rather uncommon occurrence. VIII. Owing to the relative infrequency of agonal invasion, we believe that in the majority of cases where the autopsy is performed promptly after death, the bacteria which are found in the organs succeeded in reaching these organs previously to the death agony, and are associated with the course of the disease. IX. The presence of bacteria in the organs of late autopsies is due in many cases to post-mortem extension from one organ to another, and in some cases to the post-mortem growth of small numbers of genus which were distributed to the organs by means of the circulation.

ELISpot analysis of LPS-stimulated leukocytes: Human granulocytes selectively secrete IL-8, MIP-1β and TNF-α

“…Second, the septic reaction induced by injection of bacteria into animals could be reproduced by the injection of various chemical substances [21]. Third, while bacteria could easily be cultured from the blood of animals during experimental septicaemia, this was not the case in man, where it was "evident, from the large percentage of negative results even in the severest type of disease, that the search for the specific causes of disease by this method will often prove futile" [21,46]. So which was the actual pathogenic role of bacteria?…”

“…"As regards prognosis, it is evident that a negative [blood] culture does not give much assistance, while a positive result gives a very unfavorable prognosis in the majority of cases" [46]. More than a century of medical development has passed since this assertion was published, and it still holds true; bacteremia is consistently a sign of severe infection [83,[119][120][121].…”

Reducing blood culture contamination using an initial specimen diversion device

“…2,3 False positive results in blood cultures have been described for as long as there 48 have been such cultures and are primarily due to contaminants. 1,2 It has been estimated that up to 50% of positive 49 blood cultures represent contamination. 2,3 These false positive cultures, at the microbiological laboratory level, 50 require significant additional resources for workup.…”

Reducing blood culture contamination using an initial specimen diversion device

“…Bloodstream infections cause significant morbidity and mortality and their prompt identification is an essential part of modern medicine. Blood cultures, first described in the latter part of the nineteenth century 1 , are an essential element of the diagnosis and treatment of patients with such infections. However, as with all medical testing, false positive results occur and these result in delays in diagnosis, inappropriate treatment and significantly added expenses.…”

“…2,3 False positive results in blood cultures have been described for as long as there have been such cultures and are primarily due to contaminants. 1,2 It has been estimated that up to 50% of positive blood cultures represent contamination. 2,3 These false positive cultures, at the microbiological laboratory level, require significant additional resources for workup.…”