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Hemocultură - Wikipedia
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class="vector-toc-link" href="#Utilizări_medicale"> <div class="vector-toc-text"> <span class="vector-toc-numb">1</span> <span>Utilizări medicale</span> </div> </a> <ul id="toc-Utilizări_medicale-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Procedură" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Procedură"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Procedură</span> </div> </a> <button aria-controls="toc-Procedură-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Procedură subsection</span> </button> <ul id="toc-Procedură-sublist" class="vector-toc-list"> <li id="toc-Recoltare" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Recoltare"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Recoltare</span> </div> </a> <ul id="toc-Recoltare-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cultivare" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cultivare"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Cultivare</span> </div> </a> <ul id="toc-Cultivare-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Identificare" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Identificare"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Identificare</span> </div> </a> <ul id="toc-Identificare-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antibiogramă" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antibiogramă"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Antibiogramă</span> </div> </a> <ul id="toc-Antibiogramă-sublist" class="vector-toc-list"> </ul> 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vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Bibliografie"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Bibliografie</span> </div> </a> <ul id="toc-Bibliografie-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Vezi_și" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Vezi_și"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Vezi și</span> </div> </a> <ul id="toc-Vezi_și-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Cuprins" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" 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Disponibil în 21 limbi" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-21" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">21 limbi</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B2%D8%B1%D8%B9_%D8%A7%D9%84%D8%AF%D9%85" title="زرع الدم – arabă" lang="ar" hreflang="ar" data-title="زرع الدم" data-language-autonym="العربية" data-language-local-name="arabă" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Hemocultiu" title="Hemocultiu – catalană" lang="ca" hreflang="ca" data-title="Hemocultiu" data-language-autonym="Català" data-language-local-name="catalană" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Blutkultur" title="Blutkultur – germană" lang="de" hreflang="de" data-title="Blutkultur" data-language-autonym="Deutsch" data-language-local-name="germană" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-en badge-Q17437798 badge-goodarticle mw-list-item" title="articol bun"><a href="https://en.wikipedia.org/wiki/Blood_culture" title="Blood culture – engleză" lang="en" hreflang="en" data-title="Blood culture" data-language-autonym="English" data-language-local-name="engleză" class="interlanguage-link-target"><span>English</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Hemocultivo" title="Hemocultivo – spaniolă" lang="es" hreflang="es" data-title="Hemocultivo" data-language-autonym="Español" data-language-local-name="spaniolă" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Hemokultibo" title="Hemokultibo – bască" lang="eu" hreflang="eu" data-title="Hemokultibo" data-language-autonym="Euskara" data-language-local-name="bască" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%DA%A9%D8%B4%D8%AA_%D8%AE%D9%88%D9%86" title="کشت خون – persană" lang="fa" hreflang="fa" data-title="کشت خون" data-language-autonym="فارسی" data-language-local-name="persană" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Veriviljely" title="Veriviljely – finlandeză" lang="fi" hreflang="fi" data-title="Veriviljely" data-language-autonym="Suomi" data-language-local-name="finlandeză" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/H%C3%A9moculture" title="Hémoculture – franceză" lang="fr" hreflang="fr" data-title="Hémoculture" data-language-autonym="Français" data-language-local-name="franceză" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B1%D6%80%D5%B5%D5%A1%D5%B6_%D5%B4%D5%AB%D5%BB%D5%A1%D5%BE%D5%A1%D5%B5%D6%80" title="Արյան միջավայր – armeană" lang="hy" hreflang="hy" data-title="Արյան միջավայր" data-language-autonym="Հայերեն" data-language-local-name="armeană" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Emocoltura" title="Emocoltura – italiană" lang="it" hreflang="it" data-title="Emocoltura" data-language-autonym="Italiano" data-language-local-name="italiană" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%ED%98%88%EC%95%A1_%EB%B0%B0%EC%96%91_%EA%B2%80%EC%82%AC" title="혈액 배양 검사 – coreeană" lang="ko" hreflang="ko" data-title="혈액 배양 검사" data-language-autonym="한국어" data-language-local-name="coreeană" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%AC%E0%B5%8D%E0%B4%B2%E0%B4%A1%E0%B5%8D_%E0%B4%95%E0%B5%BE%E0%B4%9A%E0%B5%8D%E0%B4%9A%E0%B5%BC" title="ബ്ലഡ് കൾച്ചർ – malayalam" lang="ml" hreflang="ml" data-title="ബ്ലഡ് കൾച്ചർ" data-language-autonym="മലയാളം" data-language-local-name="malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Bloedkweek" title="Bloedkweek – neerlandeză" lang="nl" hreflang="nl" data-title="Bloedkweek" data-language-autonym="Nederlands" data-language-local-name="neerlandeză" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Blodkultur" title="Blodkultur – norvegiană bokmål" lang="nb" hreflang="nb" data-title="Blodkultur" data-language-autonym="Norsk bokmål" data-language-local-name="norvegiană bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Posiew_krwi" title="Posiew krwi – poloneză" lang="pl" hreflang="pl" data-title="Posiew krwi" data-language-autonym="Polski" data-language-local-name="poloneză" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Hemocultura" title="Hemocultura – portugheză" lang="pt" hreflang="pt" data-title="Hemocultura" data-language-autonym="Português" data-language-local-name="portugheză" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A5%D0%B5%D0%BC%D0%BE%D0%BA%D1%83%D0%BB%D1%82%D1%83%D1%80%D0%B0" title="Хемокултура – sârbă" lang="sr" hreflang="sr" data-title="Хемокултура" data-language-autonym="Српски / srpski" data-language-local-name="sârbă" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B9%80%E0%B8%9E%E0%B8%B2%E0%B8%B0%E0%B9%80%E0%B8%8A%E0%B8%B7%E0%B9%89%E0%B8%AD%E0%B8%88%E0%B8%B2%E0%B8%81%E0%B9%80%E0%B8%A5%E0%B8%B7%E0%B8%AD%E0%B8%94" title="การเพาะเชื้อจากเลือด – thailandeză" lang="th" hreflang="th" data-title="การเพาะเชื้อจากเลือด" data-language-autonym="ไทย" data-language-local-name="thailandeză" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Kan_k%C3%BClt%C3%BCr%C3%BC" title="Kan kültürü – turcă" lang="tr" hreflang="tr" data-title="Kan kültürü" data-language-autonym="Türkçe" data-language-local-name="turcă" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%A1%80%E6%B6%B2%E5%9F%B9%E9%A4%8A" title="血液培養 – chineză" lang="zh" hreflang="zh" data-title="血液培養" data-language-autonym="中文" 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Diferențele față de <a class="external text" href="https://ro.wikipedia.org/wiki/Hemocultur%C4%83">versiunea curentă</a> pot fi semnificative.</div> <div id="viewingold-plain" style="display:none;">Versiune creată de <a href="/wiki/Utilizator:Alex_Nico" class="mw-userlink" title="Utilizator:Alex Nico" data-mw-revid="16664564"><bdi>Alex Nico</bdi></a> <span class="mw-usertoollinks">(<a href="/wiki/Discu%C8%9Bie_Utilizator:Alex_Nico" class="mw-usertoollinks-talk" title="Discuție Utilizator:Alex Nico">discuție</a> | <a href="/wiki/Special:Contribu%C8%9Bii/Alex_Nico" class="mw-usertoollinks-contribs" title="Special:Contribuții/Alex Nico">contribuții</a>)</span> la 16 noiembrie 2024 00:46</div></div><div id="mw-revision-nav">(<a href="/w/index.php?title=Hemocultur%C4%83&diff=prev&oldid=16664564" title="Hemocultură">dif</a>) <a href="/w/index.php?title=Hemocultur%C4%83&direction=prev&oldid=16664564" title="Hemocultură">← Versiunea anterioară</a> | <a href="/wiki/Hemocultur%C4%83" title="Hemocultură">afișează versiunea curentă</a> (<a href="/w/index.php?title=Hemocultur%C4%83&diff=cur&oldid=16664564" title="Hemocultură">dif</a>) | <a href="/w/index.php?title=Hemocultur%C4%83&direction=next&oldid=16664564" title="Hemocultură">Versiunea următoare →</a> (<a href="/w/index.php?title=Hemocultur%C4%83&diff=next&oldid=16664564" title="Hemocultură">dif</a>)</div></div></div></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="ro" dir="ltr"><figure typeof="mw:File/Thumb"><a href="/wiki/Fi%C8%99ier:National_Lab_Week_130410-F-TT327-090.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/ff/National_Lab_Week_130410-F-TT327-090.jpg/300px-National_Lab_Week_130410-F-TT327-090.jpg" decoding="async" width="300" height="200" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/ff/National_Lab_Week_130410-F-TT327-090.jpg/450px-National_Lab_Week_130410-F-TT327-090.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/ff/National_Lab_Week_130410-F-TT327-090.jpg/600px-National_Lab_Week_130410-F-TT327-090.jpg 2x" data-file-width="3600" data-file-height="2395" /></a><figcaption>Descărcarea flacoanele de hemocultură dintr-un aparat BACT/Alert, un sistem automat utilizat pentru incubarea hemoculturilor și detectarea creșterii microbiene</figcaption></figure> <p>O <b>hemocultură</b> este o analiză aplicată în <a href="/wiki/Laborator" title="Laborator">laboratorul</a> medical utilizată pentru a detecta <a href="/wiki/Bacterie" title="Bacterie">specii de bacterii</a> sau <a href="/wiki/Regnul_Fungi" title="Regnul Fungi">fungi</a> prezenți în <a href="/wiki/S%C3%A2nge" title="Sânge">sângele</a> unui <a href="/wiki/Pacient" title="Pacient">pacient</a>. În condiții fiziologice, normale, sângele nu conține <a href="/wiki/Microorganism" title="Microorganism">microorganisme</a>, iar prezența acestora poate indica o infecție cu <a href="/wiki/Bacterie_patogen%C4%83" title="Bacterie patogenă">bacterii patogene</a> în sânge, denumite în mod specific <a href="/wiki/Bacteriemie" title="Bacteriemie">bacteriemie</a> sau fungemie. În cazuri severe, prezența microorganismelor în sânge poate evolua spre <a href="/wiki/Septicemie" title="Septicemie">septicemie</a>. Prin <a href="/wiki/Cultur%C4%83_microbiologic%C4%83" title="Cultură microbiologică">cultivarea</a> sângelui, microbii pot fi identificați și testați pentru <a href="/wiki/Rezisten%C8%9B%C4%83_la_antibiotice" title="Rezistență la antibiotice">rezistența la antimicrobiene</a>, ceea ce permite medicilor să ofere un tratament medicamentos eficient. </p><p>Pentru realizarea hemoculturilor, sângele este prelevat în flacoane care conțin o formulă lichidă care stimulează creșterea microbiană, numită <a href="/wiki/Mediu_de_cultur%C4%83" title="Mediu de cultură">mediu de cultură</a>. De obicei, în timpul unei prelevări se colectează două recipiente, dintre care unul este conceput pentru <a href="/wiki/Organism_aerob" title="Organism aerob">organismele aerobe</a>, care necesită oxigen pentru creștere, și unul pentru <a href="/wiki/Metabolism_anaerob" title="Metabolism anaerob">organismele anaerobe</a>, care nu necesită oxigen. Aceste două recipiente sunt denumite set de hemoculturi. Uneori se colectează două seturi de hemoculturi din două locuri diferite de prelevare a sângelui. În cazul în care un microorganism apare doar într-unul dintre cele două seturi, este probabilă o contaminare a probei cu flora cutanată și nu o infecție reală a sângelui. Rezultatele fals negative pot apărea dacă eșantionul este recoltat după ce persoana a primit medicamente <a href="/wiki/Antibiotic" title="Antibiotic">antimicrobiene</a> sau dacă flacoanele nu prezintă cantitatea recomandată de sânge. Unele organisme nu se dezvoltă bine în hemoculturi și necesită tehnici speciale pentru detectare. </p><p>Recipientele în care a fost recoltat sângele sunt plasate într-un <a href="/w/index.php?title=Incubator_(microbiologie)&action=edit&redlink=1" class="new" title="Incubator (microbiologie) — pagină inexistentă">incubator</a> timp de câteva zile pentru a permite creșterea microorganismelor. Dacă se detectează o creștere microbiană, se efectuează o <a href="/wiki/Colora%C8%9Bie_Gram" title="Colorație Gram">colorație Gram</a> din flaconul de cultură pentru a confirma prezența organismelor și pentru a furniza informații preliminare cu privire la identitatea acestora. Sângele este apoi subcultivat, adică este inoculat pe o <a href="/wiki/Vas_Petri" title="Vas Petri">placă</a> de <a href="/wiki/Agar-agar" title="Agar-agar">agaroză</a> pentru a izola coloniile microbiene, în vederea identificării complete și a <a href="/wiki/Antibiogram%C4%83" title="Antibiogramă">testării susceptibilității antimicrobiene</a>. Deoarece este esențial ca infecțiile din fluxul sanguin să fie diagnosticate și tratate rapid, au fost dezvoltate metode rapide de testare utilizând tehnologii precum <a href="/wiki/Reac%C8%9Bia_%C3%AEn_lan%C8%9B_a_polimerazei" class="mw-redirect" title="Reacția în lanț a polimerazei">reacția în lanț a polimerazei</a> și <a href="/wiki/Spectrometrie_de_mas%C4%83" title="Spectrometrie de masă">spectrometria de masă</a> prin <a href="/wiki/MALDI" title="MALDI">MALDI-TOF</a>. </p><p>Procedeele de hemocultură au fost publicate încă de la mijlocul <a href="/wiki/Secolul_al_XIX-lea" title="Secolul al XIX-lea">secolului al XIX-lea</a>, însă aceste tehnici necesitau multă muncă și erau diferite față de metodele actuale. Detectarea creșterii microbiene presupunea examinarea vizuală a flacoanelor de cultură până la introducerea, în <a href="/wiki/Anii_1970" title="Anii 1970">anii 1970</a>, a sistemelor automate de hemocultură, care monitorizează gazele produse de metabolismul microbian. În țările dezvoltate, metodele manuale de hemocultură au fost în mare parte depășite de sistemele automatizate. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Utilizări_medicale"><span id="Utiliz.C4.83ri_medicale"></span>Utilizări medicale</h2></div> <p>În condiții normale, <a href="/wiki/S%C3%A2nge" title="Sânge">sângele</a> este <a href="/wiki/Sterilizare_(microbiologie)" title="Sterilizare (microbiologie)">steril</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Prezența bacteriilor în sânge se numește bacteriemie, iar prezența ciupercilor se numește fungemie.<sup id="cite_ref-turgeon-510_2-0" class="reference"><a href="#cite_note-turgeon-510-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Leziuni minore ale pielii<sup id="cite_ref-mahon-866_3-0" class="reference"><a href="#cite_note-mahon-866-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> sau ale membranelor mucoase, care pot apărea în situații variate, precum periajul dinților sau defecarea,<sup id="cite_ref-procop-188_4-0" class="reference"><a href="#cite_note-procop-188-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> pot introduce bacterii în fluxul sanguin, însă această bacteriemie este în uzual tranzitorie și este rar detectată în culturi, deoarece sistemul imunitar și sistemul reticuloendotelial identifică și distrug rapid microorganismele.<sup id="cite_ref-mahon-866_3-1" class="reference"><a href="#cite_note-mahon-866-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Bacteriile pot ajunge în sânge ca urmare a unor infecții precum celulita, infecțiile urinare și pneumonia;<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> iar infecțiile din cadrul sistemului vascular, precum endocardita bacteriană sau infecțiile asociate liniilor intravenoase, pot duce la o bacteriemie constantă.<sup id="cite_ref-procop-188_4-1" class="reference"><a href="#cite_note-procop-188-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Fungemia apare cel mai frecvent la persoanele cu un sistem imunitar cu funcționalitate scăzută.<sup id="cite_ref-turgeon-510_2-1" class="reference"><a href="#cite_note-turgeon-510-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> În cazul în care bacteriile sau ciupercile nu pot fi eliminate din fluxul sanguin, acestea se pot răspândi la alte organe și țesuturi,<sup id="cite_ref-mahon-866_3-2" class="reference"><a href="#cite_note-mahon-866-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> sau pot provoca un răspuns imun care duce la o afecțiune inflamatorie sistemică numită septicemie, care poate pune viața în pericol.<sup id="cite_ref-MartinezWolk2016_8-0" class="reference"><a href="#cite_note-MartinezWolk2016-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Atunci când se suspectează septicemia, apare necesitatea efectuării unei hemoculturi pentru a identifica agentul etiologic și pentru a furniza o terapie antimicrobiană țintită împotriva acestui patogen.<sup id="cite_ref-RhodesEvans2017_10-0" class="reference"><a href="#cite_note-RhodesEvans2017-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Pacienților care sunt spitalizați, au febră sau <a href="/wiki/Hipotermie" title="Hipotermie">hipotermie</a>, un număr ridicat de globule albe sau un număr scăzut de granulocite (o subclasă a leucocitelor) li se efectuează frecvent hemoculturi pentru a detecta o posibilă infecție localizată în circulația sanguină.<sup id="cite_ref-Garcia2015_11-0" class="reference"><a href="#cite_note-Garcia2015-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WillemsSmismans2012_12-0" class="reference"><a href="#cite_note-WillemsSmismans2012-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Hemoculturile sunt utilizate pentru a detecta infecțiile din sânge în neutropenia febrilă, o complicație frecventă a chimioterapiei în care febra apare alături de un număr foarte scăzut de neutrofile (globule albe care se oferă protecție împotriva agenților microbieni patogeni).<sup id="cite_ref-Naurois2016_13-0" class="reference"><a href="#cite_note-Naurois2016-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Territo2018_15-0" class="reference"><a href="#cite_note-Territo2018-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Bacteriemia este frecventă în anumite tipuri de infecții, cum ar fi meningita, artrita septică și abcesele epidurale, astfel încât hemoculturile sunt indicate în aceste condiții. În cazul infecțiilor nespecifice bacteriemiei, hemocultura poate fi totuși indicată dacă pacientul prezintă un risc ridicat de a contracta o infecție intravasculară sau dacă nu se pot obține rapid culturi de la locul principal al infecției (de exemplu, o urocultură în cazul pielonefritei sau o cultură de spută în cazul pneumoniei comunitare severe).<sup id="cite_ref-FabreSharara2020_16-0" class="reference"><a href="#cite_note-FabreSharara2020-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-uptodate_17-0" class="reference"><a href="#cite_note-uptodate-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> Hemocultura poate identifica o cauză microbiană subiacentă în caz de endocardită<sup id="cite_ref-CahillPrendergast2016_18-0" class="reference"><a href="#cite_note-CahillPrendergast2016-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> și febră de origine necunoscută.<sup id="cite_ref-Garcia2015_11-1" class="reference"><a href="#cite_note-Garcia2015-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CunhaLortholary2015_19-0" class="reference"><a href="#cite_note-CunhaLortholary2015-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>Agenții patogeni cei mai frecvent identificați în hemocultură sunt <i><a href="/wiki/Staphylococcus_aureus" class="mw-redirect" title="Staphylococcus aureus">Staphylococcus aureus</a></i>, <i><a href="/wiki/Escherichia_coli" title="Escherichia coli">Escherichia coli</a></i> și alți reprezentanți ai familiei <a href="/wiki/Enterobacteriaceae" title="Enterobacteriaceae">Enterobacteriaceae</a>, <i><a href="/wiki/Enterococcus" title="Enterococcus">Enterococcus</a></i> species, <i><a href="/wiki/Pseudomonas_aeruginosa" title="Pseudomonas aeruginosa">Pseudomonas aeruginosa</a></i> și <i><a href="/w/index.php?title=Candida_albicans&action=edit&redlink=1" class="new" title="Candida albicans — pagină inexistentă">Candida albicans</a></i>.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-dunne-epi_21-0" class="reference"><a href="#cite_note-dunne-epi-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Stafilococii coagulazo-negativi (SCN) sunt de asemenea întâlniți frecvent, însă este uzual dificil de determinat dacă aceste bacterii, care fac parte din flora normală a pielii,<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> sunt într-adevăr agenți patogeni sau doar au contaminat proba.<sup id="cite_ref-dunne-epi_21-1" class="reference"><a href="#cite_note-dunne-epi-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Totuși, în hemolculturile prelevate de la nou-născuți și copii, prezența SCN poate indica o infecție importantă.<sup id="cite_ref-pmid22488538_23-0" class="reference"><a href="#cite_note-pmid22488538-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> În plus, <a href="/w/index.php?title=Epidemologie&action=edit&redlink=1" class="new" title="Epidemologie — pagină inexistentă">epidemiologia</a> infecțiilor sanguine variază în funcție de loc și de timp; bacteriile <a href="/wiki/Gram-pozitiv" class="mw-redirect" title="Gram-pozitiv">Gram-pozitive</a> au devenit predominante față de cele <a href="/wiki/Gram-negativ" class="mw-redirect" title="Gram-negativ">Gram-negative</a> în ceea ce privește etiologia bacteriemiei în <a href="/wiki/Statele_Unite_ale_Americii" title="Statele Unite ale Americii">Statele Unite ale Americii</a>, în perioada anilor 1980 și 1990,<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> iar numărul cazurilor de fungemie a crescut semnificativ datorită numărului de pacienți aflați sub tratament cu medicație imunosupresivă, precum chimioterapia.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Septicemia indusă de bacterii Gram-negative este mai frecventă în regiuni precum America Centrală și de Sud, Europa de Est și Asia, în comparație cu America de Nord și Europa de Vest. În Africa, specia <i><a href="/w/index.php?title=Salmonella_enterica&action=edit&redlink=1" class="new" title="Salmonella enterica — pagină inexistentă">Salmonella enterica</a></i> este principala cauză de bacteriemie.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Procedură"><span id="Procedur.C4.83"></span>Procedură</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/Fi%C8%99ier:Bloodculturetubes.JPG" class="mw-file-description"><img alt="Three clear bottles with differently coloured caps and labels." src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Bloodculturetubes.JPG/220px-Bloodculturetubes.JPG" decoding="async" width="220" height="215" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Bloodculturetubes.JPG/330px-Bloodculturetubes.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Bloodculturetubes.JPG/440px-Bloodculturetubes.JPG 2x" data-file-width="1226" data-file-height="1199" /></a><figcaption>Flacoane de recoltare pentru hemocultură, pentru anaerob, aerob, și hemolcutură pediatrică</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Recoltare">Recoltare</h3></div> <p>De obicei, hemoculturile sunt prelevate prin <a href="/w/index.php?title=Punc%C8%9Bie&action=edit&redlink=1" class="new" title="Puncție — pagină inexistentă">puncție</a> venoasă. Nu se recomandă recoltarea probei dintr-o linie intravenoasă, deoarece acest procedeu este asociat cu rate mai ridicate de contaminare, iar culturile pot fi recoltate atât prin puncție, cât și dintr-o linie intravenoasă, pentru a diagnostica infecțiile asociate <a href="/wiki/Cateter" title="Cateter">cateterelor</a>.<sup id="cite_ref-Garcia2015_11-2" class="reference"><a href="#cite_note-Garcia2015-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-cdc_27-0" class="reference"><a href="#cite_note-cdc-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Înainte de recoltarea sângelui, partea superioară a fiecărui flacon de recoltare este <a href="/wiki/Dezinfectare" title="Dezinfectare">dezinfectată</a> cu un șervețel cu <a href="/wiki/Alcool" title="Alcool">alcool</a> pentru a preveni contaminarea.<sup id="cite_ref-Garcia2015_11-3" class="reference"><a href="#cite_note-Garcia2015-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Pielea din locul recoltării este de asemenea dezinfectată. Unele protocoale recomandă dezinfecția cu un <a href="/wiki/Antiseptic" title="Antiseptic">antiseptic</a> pe bază de alcool urmat fie de <a href="/wiki/Clorhexidin%C4%83" title="Clorhexidină">clorhexidină</a>, fie de un preparat pe bază de <a href="/wiki/Iod" title="Iod">iod</a>,<sup id="cite_ref-cdc_27-1" class="reference"><a href="#cite_note-cdc-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-mahon-869_28-0" class="reference"><a href="#cite_note-mahon-869-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> în timp ce alte protocoale consideră că este suficientă utilizarea unui antiseptic care conține doar alcool.<sup id="cite_ref-uptodate_17-1" class="reference"><a href="#cite_note-uptodate-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DoernCarroll2019_29-0" class="reference"><a href="#cite_note-DoernCarroll2019-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Dacă este necesară prelevarea sângelui pentru alte teste realizate în paralel cu hemocultura, se prelevează mai întâi flacoanele de cultură pentru a minimiza riscul de contaminare.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Deoarece <a href="/wiki/Antibiotic" title="Antibiotic">terapia antimicrobiană</a> poate cauza rezultate fals negative prin inhibarea creșterii microbilor, se recomandă ca hemoculturile să fie prelevate înainte de administrarea acestora, fapt care este de impracticabil la pacienții cu patologii severe.<sup id="cite_ref-RhodesEvans2017_10-1" class="reference"><a href="#cite_note-RhodesEvans2017-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>O recoltare tipică a hemoculturii implică prelevarea de sânge în două flacoane, care formează împreună un „set” de hemocultură. Un flacon este destinat creșterii organismelor aerobe, iar celălalt este conceput pentru a induce creșterea organismele anaerobe. La copii, infecția cu bacterii anaerobe este mai puțin frecventă, astfel încât se poate recolta un singur flacon de creștere aerobă, pentru a minimiza cantitatea de sânge prelevată.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Se recomandă recoltarea a cel puțin două seturi din două locuri separate de puncție venoasă. Acest lucru ajută la distingerea infecției de contaminare microbiană, deoarece este mai puțin probabil ca un contaminant să apară în mai mult de un set decât agenții patogeni din sânge. În plus, recoltarea unor volume mai mari de sânge crește probabilitatea ca microorganismele să fie detectate dacă sunt prezente.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p>Flacoanele de hemocultură conțin un <a href="/wiki/Mediu_de_cultur%C4%83" title="Mediu de cultură">mediu de creștere</a> care stimulează microorganismele să se înmulțească, precum și un <a href="/wiki/Anticoagulant" title="Anticoagulant">anticoagulant</a> care împiedică <a href="/wiki/Coagulare" title="Coagulare">coagularea</a> sângelui.<sup id="cite_ref-dunne-bottle_33-0" class="reference"><a href="#cite_note-dunne-bottle-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> Polianetol sulfonatul de sodiu este cel mai frecvent agent utilizat ca anticoagulant<sup id="cite_ref-dunne-bottle_33-1" class="reference"><a href="#cite_note-dunne-bottle-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> deoarece nu interferează cu creșterea majorității organismelor.<sup id="cite_ref-mahon-869_28-1" class="reference"><a href="#cite_note-mahon-869-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Compoziția exactă a mediului de creștere variază; flacoanele de cultură aerobă conțin un bulion îmbogățit cu substanțe nutritive, cum ar fi bulionul BHI (din <a href="/wiki/Limba_englez%C4%83" title="Limba engleză">engleză</a> <span lang="en" style="font-style:italic">Brain-heart infusion</span>, „bulion creier-inimă”) sau bulionul TSB (din <a href="/wiki/Limba_englez%C4%83" title="Limba engleză">engleză</a> <span lang="en" style="font-style:italic">Tryptic soy broth</span>),<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> iar flacoanele de cultură anaerobă conțin de obicei un <a href="/wiki/Agent_reduc%C4%83tor" title="Agent reducător">agent reducător</a>, cum ar fi <a href="/wiki/Acid_tioglicolic" title="Acid tioglicolic">tioglicolatul de sodiu</a>. Spațiul liber dintr-un flacon anaerob este umplut cu un amestec de gaze care în care nu se află oxigen.<sup id="cite_ref-dunne-bottle_33-2" class="reference"><a href="#cite_note-dunne-bottle-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ford-85_35-0" class="reference"><a href="#cite_note-ford-85-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>Multe dintre flacoanele disponibile comercial conțin o <a href="/wiki/R%C4%83%C8%99in%C4%83" class="mw-disambig" title="Rășină">rășină</a> care absoarbe antibioticele pentru a reduce acțiunea acestora asupra microorganismelor din probă.<sup id="cite_ref-Garcia2015_11-4" class="reference"><a href="#cite_note-Garcia2015-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Flacoanele destinate uzului pediatric sunt concepute pentru a acomoda volume mai mici de sânge și au aditivi care sporesc creșterea agenților patogeni mai frecvent întâlniți la copii.<sup id="cite_ref-Dien2016_36-0" class="reference"><a href="#cite_note-Dien2016-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> Alte recipiente sunt specializate și sunt utilizate pentru detectarea <a href="/wiki/Regnul_Fungi" title="Regnul Fungi">levurilor</a> și a <a href="/wiki/Mycobacterium" title="Mycobacterium">micobacteriilor</a>.<sup id="cite_ref-ford-85_35-1" class="reference"><a href="#cite_note-ford-85-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> În țările cu venituri mici și medii, flacoanele de cultură preformulate pot avea un cost mult prea ridicat și poate fi necesară pregătirea manuală a flacoanelor. Accesul la consumabilele și facilitățile adecvate acestui proces poate fi dificil,<sup id="cite_ref-Baron2019_37-0" class="reference"><a href="#cite_note-Baron2019-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> iar în unele regiuni, este posibil să nu se poată efectua deloc hemoculturi.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p><p>Este important ca flacoanele de hemocultură să nu fie nici insuficient umplute, dar nici prea pline: umplerea insuficientă poate duce la rezultate fals negative, deoarece în eșantion sunt prezente prea puține organisme, în timp ce umplerea excesivă poate inhiba creșterea microbiană, deoarece raportul dintre mediul de cultură și sânge este comparativ mai mic. În general, este sugerat un raport de 1:10 până la 1:5 între sânge și mediul de cultură pentru a optimiza creșterea microbiană.<sup id="cite_ref-mahon-869_28-2" class="reference"><a href="#cite_note-mahon-869-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-dunne-bp_39-0" class="reference"><a href="#cite_note-dunne-bp-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Pentru hemoculturile de rutină la adulți, Clinical and Laboratory Standards Institute (CLSI) recomandă colectarea a două seturi de flacoane din două prelevări diferite, cu 20-30 mL de sânge prelevat în fiecare set.<sup id="cite_ref-Garcia2015_11-5" class="reference"><a href="#cite_note-Garcia2015-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> La copii, cantitatea de sânge care trebuie prelevată se bazează adesea pe vârsta sau greutatea copilului.<sup id="cite_ref-Dien2016_36-1" class="reference"><a href="#cite_note-Dien2016-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> Dacă se suspectează <a href="/wiki/Endocardit%C4%83" title="Endocardită">endocardită</a>, se pot colecta șase flacoane.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cultivare">Cultivare</h3></div> <figure class="mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/Fi%C8%99ier:Signs_of_growth_in_manual_blood_culture_systems.jpg" class="mw-file-description"><img alt="Vezi legendă imagine." src="//upload.wikimedia.org/wikipedia/commons/thumb/6/66/Signs_of_growth_in_manual_blood_culture_systems.jpg/300px-Signs_of_growth_in_manual_blood_culture_systems.jpg" decoding="async" width="300" height="235" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/66/Signs_of_growth_in_manual_blood_culture_systems.jpg/450px-Signs_of_growth_in_manual_blood_culture_systems.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/66/Signs_of_growth_in_manual_blood_culture_systems.jpg/600px-Signs_of_growth_in_manual_blood_culture_systems.jpg 2x" data-file-width="765" data-file-height="598" /></a><figcaption>Indicații ale creșterii microbiene în hemoculturi manuale: a) formarea unui film (peliculă) la suprafață; b) bule datorată producerii gazelor; c) <a href="/wiki/Turbiditate" title="Turbiditate">turbiditate</a> cauzată de creșterea microbiană (flaconul din dreapta); d) colonii microbiene vizibile<sup id="cite_ref-OmbeletBarbé2019_42-0" class="reference"><a href="#cite_note-OmbeletBarbé2019-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>După recoltarea sângelui, flacoanele sunt incubate la temperatura corpului pentru a favoriza dezvoltarea microorganismelor. Recipientele sunt de obicei incubate timp de până la cinci zile în sistemele automate,<sup id="cite_ref-mahon-871_43-0" class="reference"><a href="#cite_note-mahon-871-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> deși cei mai comuni agenți patogeni din sânge sunt detectați în maximum 48 de ore.<sup id="cite_ref-ford-88_44-0" class="reference"><a href="#cite_note-ford-88-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> Perioada de incubare poate fi prelungită dacă se utilizează metodele manuale de hemocultură sau dacă sunt suspectate organisme cu creștere mai lentă, cum ar fi anumite bacterii care provoacă endocardita.<sup id="cite_ref-mahon-871_43-1" class="reference"><a href="#cite_note-mahon-871-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-auto2_45-0" class="reference"><a href="#cite_note-auto2-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> În sistemele manuale, flacoanele sunt examinate vizual pentru a observa indicatori ai creșterii microbiene, mai exact: <a href="/wiki/Turbiditate" title="Turbiditate">turbiditate</a>, producerea de <a href="/wiki/Gaz" title="Gaz">gaze</a>, prezența unor colonii microbiene vizibile sau o schimbare de culoare datorată digestiei sângelui (denumită <a href="/w/index.php?title=Hemoliz%C4%83&action=edit&redlink=1" class="new" title="Hemoliză — pagină inexistentă">hemoliză</a>). Unele sisteme manuale de hemocultură indică prezența microorganismelor folosind un compartiment care se umple cu lichid atunci când se produc gaze sau o placă de agar miniaturală care este inoculată periodic prin răsturnarea flaconului.<sup id="cite_ref-auto1_46-0" class="reference"><a href="#cite_note-auto1-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> Pentru a se asigura că hemoculturile pozitive nu au rămas neidentificate, o probă din flacon este adesea inoculată pe o placă de agaroză (subcultivată sau dispersată) la sfârșitul perioadei de incubare, indiferent dacă se observă sau nu indicatori de creștere.<sup id="cite_ref-ford-87_47-0" class="reference"><a href="#cite_note-ford-87-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p><p>În țările dezvoltate, metodele de cultură manuală au fost înlocuite în mare parte de sisteme automatizate, care asigură monitorizarea computerizată continuă a flacoanelor de cultură.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> Aceste sisteme, precum BACTEC, BacT/ALERT și VersaTrek, constau într-un incubator în care flacoanele de cultură sunt amestecate continuu. Creșterea este detectată de senzori care măsoară nivelurile de gaze din interiorul flaconului (cel mai frecvent, <a href="/wiki/Dioxid_de_carbon" title="Dioxid de carbon">dioxid de carbon</a>), care servesc drept indicator al <a href="/wiki/Metabolism" title="Metabolism">metabolismului</a> microbian.<sup id="cite_ref-auto1_46-1" class="reference"><a href="#cite_note-auto1-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> O alarmă sau un indicator vizual avertizează personalul din laborator cu privire la prezența unei hemoculturi pozitive.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> Dacă recipientul este rămâne negativ la sfârșitul perioadei de incubare, acesta este în general aruncat fără a fi subcultivat.<sup id="cite_ref-ford-87_47-1" class="reference"><a href="#cite_note-ford-87-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p><p>Tehnica prin liză și centrifugare poate fi utilizată pentru izolarea mai eficientă a microorganismelor cu creștere lentă sau fastidioase (pretențioase nutritiv), cum ar fi levurile, micobacteriile și speciile de <i><a href="/wiki/Legionella" title="Legionella">Legionella</a></i>.<sup id="cite_ref-mahon-872_50-0" class="reference"><a href="#cite_note-mahon-872-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> În locul incubării sângelui într-un flacon umplut cu mediu de creștere,[52] această metodă presupune colectarea sângelui într-un tub care conține un agent care distruge (lizează) <a href="/wiki/Eritrocit" title="Eritrocit">celulele roșii</a> și <a href="/wiki/Leucocit%C4%83" title="Leucocită">albe</a> din sânge, apoi are loc <a href="/wiki/Centrifugare" title="Centrifugare">centrifugarea</a> probei într-o <a href="/wiki/Centrifug%C4%83" title="Centrifugă">centrifugă</a>. Acest proces concentrează conținutul solid al probei, inclusiv microorganismele prezente, într-un sediment, care este utilizat apoi pentru inocularea mediului de cultură. Deși liza urmată de centrifugare oferă o sensibilitate mai mare comparativ cu metodele convenționale de hemocultură, aceasta este susceptibilă la contaminare, deoarece necesită o manipulare extensivă a probei.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Identificare">Identificare</h3></div> <div class="mw-heading mw-heading3"><h3 id="Antibiogramă"><span id="Antibiogram.C4.83"></span>Antibiogramă</h3></div> <div class="mw-heading mw-heading2"><h2 id="Limitări"><span id="Limit.C4.83ri"></span>Limitări</h2></div> <div class="mw-heading mw-heading2"><h2 id="Istoric">Istoric</h2></div> <div class="mw-heading mw-heading2"><h2 id="Note">Note</h2></div> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><b><a href="#cite_ref-1">^</a></b> <span class="reference-text">Carroll, KC <i>et al</i>. (2015). p. 755.</span> </li> <li id="cite_note-turgeon-510-2">^ <a href="#cite_ref-turgeon-510_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-turgeon-510_2-1"><sup><i><b>b</b></i></sup></a> <span class="reference-text">Turgeon, ML (2016). p. 510.</span> </li> <li id="cite_note-mahon-866-3">^ <a href="#cite_ref-mahon-866_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-mahon-866_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-mahon-866_3-2"><sup><i><b>c</b></i></sup></a> <span class="reference-text">Mahon, CR <i>et al.</i> (2018). p. 866.</span> </li> <li id="cite_note-procop-188-4">^ <a href="#cite_ref-procop-188_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-procop-188_4-1"><sup><i><b>b</b></i></sup></a> <span class="reference-text">Procop, GW & Koneman, EW (2017). p. 188.</span> </li> <li id="cite_note-5"><b><a href="#cite_ref-5">^</a></b> <span class="reference-text">Pitt, SJ (2018). p. 26.</span> </li> <li id="cite_note-6"><b><a href="#cite_ref-6">^</a></b> <span class="reference-text">Carroll, KC <i>et al</i>. (2015) pp. 755–6.</span> </li> <li id="cite_note-7"><b><a href="#cite_ref-7">^</a></b> <span class="reference-text">Mahon, CR <i>et al</i>. (2018). p. 867.</span> </li> <li id="cite_note-MartinezWolk2016-8"><b><a href="#cite_ref-MartinezWolk2016_8-0">^</a></b> <span class="reference-text"><cite class="citation journal">Martinez, RM; Wolk, DM (<time datetime="2016">2016</time>). „Bloodstream Infections”. <i>Microbiology Spectrum</i>. <b>4</b> (4). <a href="/wiki/Digital_object_identifier" title="Digital object identifier">doi</a>:<span class="plainlinks"><a rel="nofollow" class="external text" href="https://doi.org/10.1128%2Fmicrobiolspec.DMIH2-0031-2016">10.1128/microbiolspec.DMIH2-0031-2016</a> <span typeof="mw:File"><span title="Accesibil gratuit"><img alt="Accesibil gratuit" src="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png" decoding="async" width="9" height="14" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/14px-Lock-green.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/18px-Lock-green.svg.png 2x" data-file-width="512" data-file-height="813" /></span></span></span>. <a href="/wiki/International_Standard_Serial_Number" title="International Standard Serial Number">ISSN</a> <a rel="nofollow" class="external text" href="//www.worldcat.org/issn/2165-0497">2165-0497</a>. <a href="/wiki/PubMed_Identifier" title="PubMed Identifier">PMID</a> <a rel="nofollow" class="external text" href="//www.ncbi.nlm.nih.gov/pubmed/27726765">27726765</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Microbiology+Spectrum&rft.atitle=Bloodstream+Infections&rft.volume=4&rft.issue=4&rft.date=2016&rft.issn=2165-0497&rft_id=info%3Apmid%2F27726765&rft_id=info%3Adoi%2F10.1128%2Fmicrobiolspec.DMIH2-0031-2016&rft.aulast=Martinez&rft.aufirst=RM&rft.au=Wolk%2C+DM&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><style data-mw-deduplicate="TemplateStyles:r16236537">.mw-parser-output cite.citation{font-style:inherit}.mw-parser-output .citation q{quotes:"„""”""«""»"}.mw-parser-output .citation .cs1-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .citation .cs1-lock-limited a,.mw-parser-output .citation .cs1-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Lock-gray-alt-2.svg/9px-Lock-gray-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .citation .cs1-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Lock-red-alt-2.svg/9px-Lock-red-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/12px-Wikisource-logo.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{font-size:100%}.mw-parser-output .cs1-maint{display:none;color:#33aa33;margin-left:0.3em}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}</style></span> </li> <li id="cite_note-9"><b><a href="#cite_ref-9">^</a></b> <span class="reference-text">Bennett, JE <i>et al</i>. (2019). p. 990.</span> </li> <li id="cite_note-RhodesEvans2017-10">^ <a href="#cite_ref-RhodesEvans2017_10-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-RhodesEvans2017_10-1"><sup><i><b>b</b></i></sup></a> <span class="reference-text"><cite class="citation journal">Rhodes, A; Evans, E; Alhazzani, W; Levy, MM; Antonelli, M; Ferrer, R; et al. (<time datetime="2017">2017</time>). „Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016”. <i>Intensive Care Medicine</i>. <b>43</b> (3): 304–377. <a href="/wiki/Digital_object_identifier" title="Digital object identifier">doi</a>:<span class="plainlinks"><a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00134-017-4683-6">10.1007/s00134-017-4683-6</a> <span typeof="mw:File"><span title="Accesibil gratuit"><img alt="Accesibil gratuit" src="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png" decoding="async" width="9" height="14" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/14px-Lock-green.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/18px-Lock-green.svg.png 2x" data-file-width="512" data-file-height="813" /></span></span></span>. <a href="/wiki/International_Standard_Serial_Number" title="International Standard Serial Number">ISSN</a> <a rel="nofollow" class="external text" href="//www.worldcat.org/issn/0342-4642">0342-4642</a>. <a href="/wiki/PubMed_Identifier" title="PubMed Identifier">PMID</a> <a rel="nofollow" class="external text" href="//www.ncbi.nlm.nih.gov/pubmed/28101605">28101605</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Intensive+Care+Medicine&rft.atitle=Surviving+Sepsis+Campaign%3A+International+Guidelines+for+Management+of+Sepsis+and+Septic+Shock%3A+2016&rft.volume=43&rft.issue=3&rft.pages=304-377&rft.date=2017&rft.issn=0342-4642&rft_id=info%3Apmid%2F28101605&rft_id=info%3Adoi%2F10.1007%2Fs00134-017-4683-6&rft.aulast=Rhodes&rft.aufirst=A&rft.au=Evans%2C+E&rft.au=Alhazzani%2C+W&rft.au=Levy%2C+MM&rft.au=Antonelli%2C+M&rft.au=Ferrer%2C+R&rft.au=Kumar%2C+Anand&rft.au=Sevransky%2C+Jonathan+E.&rft.au=Sprung%2C+Charles+L.&rft.au=Nunnally%2C+Mark+E&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></span> </li> <li id="cite_note-Garcia2015-11">^ <a href="#cite_ref-Garcia2015_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Garcia2015_11-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Garcia2015_11-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Garcia2015_11-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Garcia2015_11-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Garcia2015_11-5"><sup><i><b>f</b></i></sup></a> <span class="error mw-ext-cite-error" lang="ro" dir="ltr">Eroare la citare: Etichetă <code><ref></code> invalidă; niciun text nu a fost furnizat pentru referințele numite <code>Garcia2015</code></span></li> <li id="cite_note-WillemsSmismans2012-12"><b><a href="#cite_ref-WillemsSmismans2012_12-0">^</a></b> <span class="reference-text"><cite class="citation journal">Willems, E; Smismans, A; Cartuyvels, R; Coppens, G; Van Vaerenbergh, K; Van den Abeele, AM; Frans, J (<time datetime="2012">2012</time>). „The preanalytical optimization of blood cultures: a review and the clinical importance of benchmarking in 5 Belgian hospitals”. <i>Diagnostic Microbiology and Infectious Disease</i>. <b>73</b> (1): 1–8. <a href="/wiki/Digital_object_identifier" title="Digital object identifier">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.diagmicrobio.2012.01.009">10.1016/j.diagmicrobio.2012.01.009</a>. <a href="/wiki/International_Standard_Serial_Number" title="International Standard Serial Number">ISSN</a> <a rel="nofollow" class="external text" href="//www.worldcat.org/issn/0732-8893">0732-8893</a>. <a href="/wiki/PubMed_Identifier" title="PubMed Identifier">PMID</a> <a rel="nofollow" class="external text" href="//www.ncbi.nlm.nih.gov/pubmed/22578933">22578933</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Diagnostic+Microbiology+and+Infectious+Disease&rft.atitle=The+preanalytical+optimization+of+blood+cultures%3A+a+review+and+the+clinical+importance+of+benchmarking+in+5+Belgian+hospitals&rft.volume=73&rft.issue=1&rft.pages=1-8&rft.date=2012&rft.issn=0732-8893&rft_id=info%3Apmid%2F22578933&rft_id=info%3Adoi%2F10.1016%2Fj.diagmicrobio.2012.01.009&rft.aulast=Willems&rft.aufirst=E&rft.au=Smismans%2C+A&rft.au=Cartuyvels%2C+R&rft.au=Coppens%2C+G&rft.au=Van+Vaerenbergh%2C+K&rft.au=Van+den+Abeele%2C+AM&rft.au=Frans%2C+J&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></span> </li> <li id="cite_note-Naurois2016-13"><b><a href="#cite_ref-Naurois2016_13-0">^</a></b> <span class="reference-text"><cite class="citation journal">Klastersky, J; de Naurois; Rolston, K; Rapoport, B; Maschmeyer, G; Aapro, M; Herrstedt, J. 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(2019). pp. 172–3.</span> </li> <li id="cite_note-dunne-bp-39"><b><a href="#cite_ref-dunne-bp_39-0">^</a></b> <span class="reference-text">Tibbetts, RJ & Robinson-Dunn, B. Chapter 10 in Dunne, WM & Burnham, CAD <i>eds.</i> (2018). sec. "Introduction".</span> </li> <li id="cite_note-40"><b><a href="#cite_ref-40">^</a></b> <span class="reference-text">Revell, P & Doern, C. Chapter 8 in Dunne, WM & Burnham, CAD eds. (2018). sec. "Specimen Collection".</span> </li> <li id="cite_note-41"><b><a href="#cite_ref-41">^</a></b> <span class="reference-text">Bennett, JE <i>et al</i>. (2019). p. 202.</span> </li> <li id="cite_note-OmbeletBarbé2019-42"><b><a href="#cite_ref-OmbeletBarbé2019_42-0">^</a></b> <span class="error mw-ext-cite-error" lang="ro" dir="ltr">Eroare la citare: Etichetă <code><ref></code> invalidă; niciun text nu a fost furnizat pentru referințele numite <code>OmbeletBarbé2019</code></span></li> <li id="cite_note-mahon-871-43">^ <a href="#cite_ref-mahon-871_43-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-mahon-871_43-1"><sup><i><b>b</b></i></sup></a> <span class="reference-text">Mahon, CR <i>et al</i>. (2018). p. 871.</span> </li> <li id="cite_note-ford-88-44"><b><a href="#cite_ref-ford-88_44-0">^</a></b> <span class="reference-text">Ford, M (2019). p. 88.</span> </li> <li id="cite_note-auto2-45"><b><a href="#cite_ref-auto2_45-0">^</a></b> <span class="reference-text">Procop, GW & Koneman, EW (2017). p. 199.</span> </li> <li id="cite_note-auto1-46">^ <a href="#cite_ref-auto1_46-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-auto1_46-1"><sup><i><b>b</b></i></sup></a> <span class="reference-text">Mahon, CR <i>et al</i>. (2018). pp. 871–2.</span> </li> <li id="cite_note-ford-87-47">^ <a href="#cite_ref-ford-87_47-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-ford-87_47-1"><sup><i><b>b</b></i></sup></a> <span class="reference-text">Ford, M (2019). p. 87.</span> </li> <li id="cite_note-48"><b><a href="#cite_ref-48">^</a></b> <span class="reference-text">Carroll, KC <i>et al</i>. (2015). p. 756.</span> </li> <li id="cite_note-49"><b><a href="#cite_ref-49">^</a></b> <span class="reference-text">Procop, GW & Koneman, EW (2017). pp. 197–8.</span> </li> <li id="cite_note-mahon-872-50"><b><a href="#cite_ref-mahon-872_50-0">^</a></b> <span class="reference-text">Mahon, CR <i>et al</i>. (2018). p. 872.</span> </li> <li id="cite_note-51"><b><a href="#cite_ref-51">^</a></b> <span class="reference-text">Procop, GW & Koneman, EW (2017). p. 196.</span> </li> <li id="cite_note-52"><b><a href="#cite_ref-52">^</a></b> <span class="reference-text">McPherson, RA & Pincus, MR (2017). p. 1207.</span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="Bibliografie">Bibliografie</h2></div> <style data-mw-deduplicate="TemplateStyles:r12727094">.mw-parser-output .refbegin{font-size:90%;margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{list-style-type:none;margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li,.mw-parser-output .refbegin-hanging-indents>dl>dd{margin-left:0;padding-left:3.2em;text-indent:-3.2em;list-style:none}.mw-parser-output .refbegin-100{font-size:100%}</style><div class="refbegin columns references-column-width" style="-moz-column-width: 30em; -webkit-column-width: 30em; column-width: 30em;"> <ul><li><cite class="citation book">Bennett, JE; Dolin, R; Blaser, MJ (<time datetime="2019-08-08">8 august 2019</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=8pKqDwAAQBAJ&pg=PT837"><i>Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases</i></a>. Elsevier Health Sciences. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-323-48255-4" title="Special:Referințe în cărți/978-0-323-48255-4">978-0-323-48255-4</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Mandell%2C+Douglas%2C+and+Bennett%27s+Principles+and+Practice+of+Infectious+Diseases&rft.pub=Elsevier+Health+Sciences&rft.date=2019-08-08&rft.isbn=978-0-323-48255-4&rft.aulast=Bennett&rft.aufirst=JE&rft.au=Dolin%2C+R&rft.au=Blaser%2C+MJ&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D8pKqDwAAQBAJ%26pg%3DPT837&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Carroll, KC; Butel, JS; Morse, SA (<time datetime="2015-08-12">12 august 2015</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=PumOCgAAQBAJ"><i>Jawetz Melnick & Adelbergs Medical Microbiology 27 E</i></a>. McGraw-Hill Education. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-07-182503-0" title="Special:Referințe în cărți/978-0-07-182503-0">978-0-07-182503-0</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Jawetz+Melnick+%26+Adelbergs+Medical+Microbiology+27+E&rft.pub=McGraw-Hill+Education&rft.date=2015-08-12&rft.isbn=978-0-07-182503-0&rft.aulast=Carroll&rft.aufirst=KC&rft.au=Butel%2C+JS&rft.au=Morse%2C+SA&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DPumOCgAAQBAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Dondorp, AM; Dünser, MW; Schultz, MJ (<time datetime="2019-02-08">8 februarie 2019</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=MkWHDwAAQBAJ"><i>Sepsis Management in Resource-limited Settings</i></a>. Springer. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-3-030-03143-5" title="Special:Referințe în cărți/978-3-030-03143-5">978-3-030-03143-5</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Sepsis+Management+in+Resource-limited+Settings&rft.pub=Springer&rft.date=2019-02-08&rft.isbn=978-3-030-03143-5&rft.aulast=Dondorp&rft.aufirst=AM&rft.au=D%C3%BCnser%2C+MW&rft.au=Schultz%2C+MJ&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DMkWHDwAAQBAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Dunne, WM; Burnham, CAD (<time datetime="2018">2018</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=_gjMDwAAQBAJ"><i>The Dark Art of Blood Cultures</i></a>. Wiley. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-1-68367-306-4" title="Special:Referințe în cărți/978-1-68367-306-4">978-1-68367-306-4</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+Dark+Art+of+Blood+Cultures&rft.pub=Wiley&rft.date=2018&rft.isbn=978-1-68367-306-4&rft.aulast=Dunne&rft.aufirst=WM&rft.au=Burnham%2C+CAD&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D_gjMDwAAQBAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Ford, M (<time datetime="2019-06-05">5 iunie 2019</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=_guXDwAAQBAJ&pg=PA90"><i>Medical Microbiology</i></a>. Oxford University Press. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-19-881814-4" title="Special:Referințe în cărți/978-0-19-881814-4">978-0-19-881814-4</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Medical+Microbiology&rft.pub=Oxford+University+Press&rft.date=2019-06-05&rft.isbn=978-0-19-881814-4&rft.aulast=Ford&rft.aufirst=M&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D_guXDwAAQBAJ%26pg%3DPA90&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Mahon, CR; Lehman, DC; Manuselis, G (<time datetime="2018-01-18">18 ianuarie 2018</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=uGRgDwAAQBAJ"><i>Textbook of Diagnostic Microbiology</i></a>. Elsevier Health Sciences. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-323-48212-7" title="Special:Referințe în cărți/978-0-323-48212-7">978-0-323-48212-7</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Textbook+of+Diagnostic+Microbiology&rft.pub=Elsevier+Health+Sciences&rft.date=2018-01-18&rft.isbn=978-0-323-48212-7&rft.aulast=Mahon&rft.aufirst=CR&rft.au=Lehman%2C+DC&rft.au=Manuselis%2C+G&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DuGRgDwAAQBAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">McPherson, RA; Pincus, MR (<time datetime="2017-04-05">5 aprilie 2017</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=xAzhCwAAQBAJ"><i>Henry's Clinical Diagnosis and Management by Laboratory Methods</i></a> (ed. 23). Elsevier Health Sciences. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-323-41315-2" title="Special:Referințe în cărți/978-0-323-41315-2">978-0-323-41315-2</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Henry%27s+Clinical+Diagnosis+and+Management+by+Laboratory+Methods&rft.edition=23&rft.pub=Elsevier+Health+Sciences&rft.date=2017-04-05&rft.isbn=978-0-323-41315-2&rft.aulast=McPherson&rft.aufirst=RA&rft.au=Pincus%2C+MR&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DxAzhCwAAQBAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Pagana, KD; Pagana, TJ; Pagana, TN (<time datetime="2014-09-19">19 septembrie 2014</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=J7eXBAAAQBAJ&pg=PR13"><i>Mosby's Diagnostic and Laboratory Test Reference - E-Book</i></a>. Elsevier Health Sciences. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-323-22592-2" title="Special:Referințe în cărți/978-0-323-22592-2">978-0-323-22592-2</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Mosby%27s+Diagnostic+and+Laboratory+Test+Reference+-+E-Book&rft.pub=Elsevier+Health+Sciences&rft.date=2014-09-19&rft.isbn=978-0-323-22592-2&rft.aulast=Pagana&rft.aufirst=KD&rft.au=Pagana%2C+TJ&rft.au=Pagana%2C+TN&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DJ7eXBAAAQBAJ%26pg%3DPR13&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Pitt, SJ (<time datetime="2018">2018</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=Oso9DwAAQBAJ"><i>Clinical Microbiology for Diagnostic Laboratory Scientists</i></a>. Wiley. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-1-118-74582-3" title="Special:Referințe în cărți/978-1-118-74582-3">978-1-118-74582-3</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Clinical+Microbiology+for+Diagnostic+Laboratory+Scientists&rft.pub=Wiley&rft.date=2018&rft.isbn=978-1-118-74582-3&rft.aulast=Pitt&rft.aufirst=SJ&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DOso9DwAAQBAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Procop, GW; Koneman, EW (<time datetime="2017">2017</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=a9ogywAACAAJ"><i>Koneman's Color Atlas and Textbook of Diagnostic Microbiology</i></a>. Wolters Kluwer Health. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-1-4511-1659-5" title="Special:Referințe în cărți/978-1-4511-1659-5">978-1-4511-1659-5</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Koneman%27s+Color+Atlas+and+Textbook+of+Diagnostic+Microbiology&rft.pub=Wolters+Kluwer+Health&rft.date=2017&rft.isbn=978-1-4511-1659-5&rft.aulast=Procop&rft.aufirst=GW&rft.au=Koneman%2C+EW&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3Da9ogywAACAAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Truant, AL (<time datetime="2016-03-28">28 martie 2016</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=BO7bCwAAQBAJ&pg=PA13"><i>Manual of Commercial Methods in Clinical Microbiology</i></a>. Wiley. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-1-119-02186-5" title="Special:Referințe în cărți/978-1-119-02186-5">978-1-119-02186-5</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Manual+of+Commercial+Methods+in+Clinical+Microbiology&rft.pub=Wiley&rft.date=2016-03-28&rft.isbn=978-1-119-02186-5&rft.aulast=Truant&rft.aufirst=AL&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DBO7bCwAAQBAJ%26pg%3DPA13&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Turgeon, ML (<time datetime="2016">2016</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=QyvRoQEACAAJ"><i>Linné & Ringsrud's Clinical Laboratory Science: Concepts, Procedures, and Clinical Applications</i></a> (ed. 7). Elsevier Mosby. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-323-22545-8" title="Special:Referințe în cărți/978-0-323-22545-8">978-0-323-22545-8</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Linn%C3%A9+%26+Ringsrud%27s+Clinical+Laboratory+Science%3A+Concepts%2C+Procedures%2C+and+Clinical+Applications&rft.edition=7&rft.pub=Elsevier+Mosby&rft.date=2016&rft.isbn=978-0-323-22545-8&rft.aulast=Turgeon&rft.aufirst=ML&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DQyvRoQEACAAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li> <li><cite class="citation book">Walls, R; Hockberger, R; Gausche-Hill, M (<time datetime="2017-03-09">9 martie 2017</time>). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=OANODgAAQBAJ"><i>Rosen's Emergency Medicine - Concepts and Clinical Practice</i></a> (ed. 9). Elsevier Health Sciences. <a href="/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="/wiki/Special:Referin%C8%9Be_%C3%AEn_c%C4%83r%C8%9Bi/978-0-323-39016-3" title="Special:Referințe în cărți/978-0-323-39016-3">978-0-323-39016-3</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Rosen%27s+Emergency+Medicine+-+Concepts+and+Clinical+Practice&rft.edition=9&rft.pub=Elsevier+Health+Sciences&rft.date=2017-03-09&rft.isbn=978-0-323-39016-3&rft.aulast=Walls&rft.aufirst=R&rft.au=Hockberger%2C+R&rft.au=Gausche-Hill%2C+M&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DOANODgAAQBAJ&rfr_id=info%3Asid%2Fro.wikipedia.org%3AHemocultur%C4%83" class="Z3988"><span style="display:none;"> </span></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r16236537"></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="Vezi_și"><span id="Vezi_.C8.99i"></span>Vezi și</h2></div> <ul><li><a href="/wiki/Mediu_de_cultur%C4%83" title="Mediu de cultură">Mediu de cultură</a></li> <li><a href="/w/index.php?title=Urocultur%C4%83&action=edit&redlink=1" class="new" title="Urocultură — pagină inexistentă">Urocultură</a></li></ul> <!-- NewPP limit report Parsed by mw‐web.codfw.main‐76c6b8f495‐s4sn8 Cached time: 20241128142117 Cache expiry: 2592000 Reduced expiry: false Complications: [show‐toc] CPU time usage: 0.478 seconds Real time usage: 0.676 seconds Preprocessor visited node count: 2024/1000000 Post‐expand include size: 60494/2097152 bytes Template argument size: 69/2097152 bytes Highest expansion depth: 8/100 Expensive parser function count: 0/500 Unstrip recursion depth: 1/20 Unstrip post‐expand size: 98048/5000000 bytes Lua time usage: 0.263/10.000 seconds Lua memory usage: 4049169/52428800 bytes Number of Wikibase entities loaded: 3/400 --> <!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 447.268 1 -total 35.01% 156.610 2 Format:En 22.90% 102.409 11 Format:Cite_journal 15.70% 70.204 13 Format:Cite_book 7.16% 32.033 1 Format:Control_de_autoritate 5.07% 22.665 3 Format:Cite_web 2.99% 13.355 1 Format:Refbegin 0.65% 2.886 1 Format:Column-width 0.39% 1.763 1 Format:Refend --> <!-- Saved in RevisionOutputCache with key rowiki:rcache:16664564:dateformat=default and timestamp 20241128142116 and revision id 16664564. --> </div><!--esi <esi:include src="/esitest-fa8a495983347898/content" /> --><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Adus de la <a dir="ltr" href="https://ro.wikipedia.org/w/index.php?title=Hemocultură&oldid=16664564">https://ro.wikipedia.org/w/index.php?title=Hemocultură&oldid=16664564</a></div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Special:Categorii" title="Special:Categorii">Categorii</a>: <ul><li><a href="/wiki/Categorie:Analize_sanguine" title="Categorie:Analize sanguine">Analize sanguine</a></li><li><a href="/wiki/Categorie:Tehnici_de_laborator" title="Categorie:Tehnici de laborator">Tehnici de laborator</a></li></ul></div><div id="mw-hidden-catlinks" class="mw-hidden-catlinks mw-hidden-cats-hidden">Categorii ascunse: <ul><li><a href="/wiki/Categorie:Pagini_cu_erori_de_citare" title="Categorie:Pagini cu erori de citare">Pagini cu erori de citare</a></li><li><a href="/wiki/Categorie:Articole_cu_surse_%C3%AEn_limba_spaniol%C4%83_(es)" title="Categorie:Articole cu surse în limba spaniolă (es)">Articole cu surse în limba spaniolă (es)</a></li><li><a href="/wiki/Categorie:Articole_Wikipedia_cu_control_de_autoritate" title="Categorie:Articole Wikipedia cu control de autoritate">Articole Wikipedia cu control de autoritate</a></li></ul></div></div> </div> </main> </div> <div class="mw-footer-container"> <footer id="footer" class="mw-footer" > <ul id="footer-info"> <li id="footer-info-lastmod"> Ultima editare a paginii a fost efectuată la 16 noiembrie 2024, ora 00:46.</li> <li id="footer-info-copyright">Acest text este disponibil sub licența <a rel="nofollow" class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.ro">Creative Commons cu atribuire și distribuire în condiții identice</a>; pot exista și clauze suplimentare. 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