[Blood cultures in clinical practice: Principles, procedures, and quality management].

Abstract

Blood cultures remain the cornerstone of diagnosing bloodstream infections, and their appropriate use directly impacts timely diagnosis, targeted antimicrobial therapy, and patient safety. However, their diagnostic yield and clinical interpretability are determined not only by laboratory processing itself, but also by the entire sequence of interconnected pre-analytical, analytical, and post-analytical steps. This review article summarizes the principles of blood culture testing, focusing on appropriate indications and timing of blood collection, recommended number of culture sets and blood volume, aseptic collection techniques, specimen labeling, transport, and laboratory receipt. It also addresses the analytical phase, including the selection of culture systems and media, the role of additives, incubation conditions, monitoring for positivity, and subsequent processing of positive blood cultures. Separate attention is devoted to the post-analytical phase, particularly result interpretation, reporting critical findings, blood culture contamination, surveillance of catheter-associated infections, and isolate storage. The final section focuses on quality indicators and the importance of systematic quality management throughout the entire process. The article emphasizes that blood cultures should be regarded as a complex diagnostic process, whose quality depends on the coordination of clinical and laboratory procedures, workflow standardization, and ongoing evaluation of measurable performance indicators. Keywords: blood cultures, bacteremia, fungemia, pre-analytical phase, analytical phase, post-analytical phase, blood culture contamination, quality management.