Advertisement

Sepsis pp 35-44 | Cite as

New Methods in the Microbiological Diagnosis of Septicemia

  • H. Hahn
  • G. Daeschlein
  • J. Wagner

Abstract

Septicemia — the invasion of the bloodstream by bacteria, with all its dreaded complications — continues to be an urgent medical problem that requires close cooperation between the clinician and the laboratory. Although research has improved our knowledge of the subject, septicemia still kills between 30% and 50% of its victims. In this respect, gram-negative septicemia, i. e. septicemia caused by gram-negative rods, is particularly important. In a large hospital in the United States, the following pathogens were isolated from blood cultures in 500 episodes of septicemia (after Weinstein [15]):

Staphylococcus aureus 11%

Escherichia coli 18%

Pneumococci 7%

Klebsiella pneumoniae 6%

Proteus mirabilis 2%

Pseudomonas aeruginosa 6%

Other Enterobacteriaceae 7%

Anaerobes 13%

Fungi 8%

Symptoms suggestive of septicaemia are above all fever, rigors, hypotension or vascular collapse (septic shock), tachypnoea and cardiac arrhythmias. There is usually leucocytosis with a left shift; neutrophils show toxic granulations and Döhle bodies. The platelet count is often decreased, and there may be fragmented red blood cells and disseminated intravascular coagulation (especially in meningococcal septicemia).

Keywords

Blood Culture Tuberculous Meningitis Latex Agglutination Blood Culture Bottle Fluid Serum 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Beezer AE, Bettelheim KA, Al-Salihi S, Shaw EJ (1978) The enumeration of bacteria in culture media and clinical specimens of urine by microcalorimetry. Sci Tools 25: 6–9Google Scholar
  2. 2.
    Bille J, Edson RS, Roberts GO (1984) Clinical evaluation of the lysis-centrifugation blood culture system for the detection of fungemia and comparison with a conventional biphasic broth blood culture system. J Clin Microbiol 19: 126–128PubMedGoogle Scholar
  3. 3.
    Buckland A, Kessock-Philip S, Bascomb S (1983) Early detection of bacterial growth in blood culture by impedance monitoring with a Bactometer model 32. J Clin Pathol 36: 823–828PubMedCrossRefGoogle Scholar
  4. 4.
    Falkow S (1987) The use of DNA hybridization for the identification of pathogenic bacteria. In: Habermehl KD (ed) Rapid methods and automation in microbiology and immunology. Springer, Berlin Heidelberg New York, pp 30–33Google Scholar
  5. 5.
    Fung CJ, Tilton RC (1985) Detection of bacterial antigens by counterimmunoelectrophoresis, coagglutination and latex-agglutination. In: Lenette EH (ed) Manual of clinical microbiology, 4th ed. American Society for Microbiology, pp 883–889Google Scholar
  6. 6.
    Giesbrecht P, Naumann D, Labischinski H, Barnickel G (1987) A new method for rapid identification and differentiation of pathogenic microorganisms using Fourier transform infrared spectroscopy. In: Habermehl KD (ed) Rapid methods and automation in microbiology and immunology. Springer, Berlin Heidelberg New York, pp 198–206Google Scholar
  7. 7.
    Henry NK, Melimans CA, Wright AJ, Thompson RL, Wilson WR, Washington JAI I (1983) Microbiological and clinical evaluation of the isolator lysis-centrifugation blood culture tube. J Clin Microbiol 17: 864–869PubMedGoogle Scholar
  8. 8.
    Kagan RL, Schuette WH, Zierdt CH, MacLowry JD (1977) Rapid automated diagnosis of bacteremia by impedance detection. J Clin Microbiol 5: 51–57PubMedGoogle Scholar
  9. 9.
    Kelly MT, Fojtasek MF, Abbott TM, Hale DC, Dizikes JR, Boshard R, Buck GE, Martin WJ, Matsen JM (1983) Clinical evaluation of a lysis-centrifugation technique for the detection of septicemia. JAMA 250: 2185–2188PubMedCrossRefGoogle Scholar
  10. 10.
    Kiehn TE, Wong B, Edwards FF, Armstrong D (1983) Comparative recovery of bacteria and yeasts from lysis-centrifugation and a conventional blood culture system. J Clin Microbiol 18: 300–304PubMedGoogle Scholar
  11. 11.
    Pfaller MA, Sibley TK, Westfall LM, Hoppe-Bauer JE, Keating MA, Murray PR (1982) Clinical laboratory comparison of a slide blood culture system with a conventional broth system. J Clin Microbiol 16: 525–530PubMedGoogle Scholar
  12. 12.
    Specter S, Throm R, Strauss R, Friedman H (1977) Rapid detection of bacterial growth in blood samples by a continuous-monitoring electrical impedance apparatus. J Clin Microbiol 6: 489–493PubMedGoogle Scholar
  13. 13.
    Throm R, Specter S, Strauss R, Friedman H (1977) Detection of bacteriuria by automated electrical impedance monitoring in a clinical microbiology laboratory. J Clin Microbiol 6: 271–273PubMedGoogle Scholar
  14. 14.
    Wallis C, Melnick JL, Wende RD, Riely PE (1980) Rapid isolation of bacteria from septicemic patients by use of an antimicrobial agent removal device. J Clin Microbiol 11: 462–464PubMedGoogle Scholar
  15. 15.
    Weinstein MP (1983) The clinical significance of positive blood cultures: A comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. Laboratory and epidemiologic observations. Rev Infect Dis 5: 35PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • H. Hahn
  • G. Daeschlein
  • J. Wagner

There are no affiliations available

Personalised recommendations