Аннотация
Диагностика инфекций кровотока остается актуальной проблемой системы здравоохранения. Золотым стандартом диа-
гностики септических состояний является микробиологическое исследование крови с применением автоматических бак-
териологических анализаторов (гемокультиваторов). Данное исследование позволяет выделить микроорганизм для его по-
следующей видовой идентификации, определения чувствительности к антимикробным препаратам (АМП), что определяет
оптимальную терапию для пациента. Целый ряд факторов может оказать влияние на результат посева крови: кратность
взятия проб, объем исследуемого материала, терапия АМП, состояние пациента в момент взятия крови на исследование,
корректность преаналитического этапа, условия доставки проб в лабораторию и другие. Несомненно, следование инструк-
циям производителей гемокультиваторов с оптимальным выбором флаконов с питательными средами повышает качество
аналитического этапа и вероятность выделения возбудителя. На сегодняшний день на рынке представлен широкий спектр
автоматических анализаторов гемокультур от различных производителей, предлагающих для исследований флаконы к сво-
им приборам с различными характеристиками. В обзоре представлена информация о принципе работы современных гемо-
культиваторов, результатах сравнения применения различных флаконов, способах ускоренной диагностики инфекций крово-
тока и неочевидных факторах, способных повлиять на результат микробиологического исследования крови. При написании
обзора использовался поиск литературы по библиографическим базам данных научных публикаций РИНЦ, Pubmed, Scopus.
Annotation
Diagnosis of bloodstream infections remains an urgent problem of the healthcare system. The gold standard for the diagnosis of septic
conditions is the microbiological examination of blood using automatic bacteriological analyzers (hemocultivators). This study makes
it possible to isolate a microorganism for its subsequent species identification, determination of sensitivity to antibacterial drugs,
which determines the optimal therapy for the patient. A number of factors can influence the result of blood culture: the frequency of
sampling, the volume of the test material, antibiotic therapy, the patient’s condition at the time of blood sampling, the correctness
of the preanalytical stage, the conditions for sample delivery to the laboratory, and others. Undoubtedly, following the instructions
of manufacturers of hemocultivators with an optimal choice of vials with nutrient media also improves the quality of the analytical
stage and the probability of pathogen isolation. Today, the market offers a wide range of automatic blood culture analyzers from
various manufacturers offering vials to their devices with different characteristics for research. The review provides information on the
principle of operation of modern hemocultivators, the results of comparing the use of different vials, methods for accelerated diagnosis
of bloodstream infections and non-obvious factors that can affect the result of microbiological blood testing. When writing the review,
a literature search was used in the bibliographic databases of scientific publications of the RSCI, Pubmed, and Scopus.
Key words: bloodstream infections; hemocultivators; blood culture; diagnosis of bacteremia
Список литературы
Л И Т Е РАТ У РА ( П П 1 — 8 , 1 1 — 1 6 , 1 8 — 2 9 , 3 1 — 3 3 ,
3 6 — 3 9 С М . R E F E R E N C E S )
9. Куцевалова О.Ю., Козел Ю.Ю., Алавердян А.И., Гусак Д.А. Анализ
этиологии структуры инфекций кровотока с использованием авто-
матического бактериологического анализатора Юнона® Лабстар.
Клиническая лабораторная диагностика. 2020; 67(2): 101-5. DOI:
10.51620/0869-2084-2022-67-2-101-105.
10. Боронина Л.Г., Саматова Е.В., Кукушкина М.П., Панова С.А.,
Устюгова С.С. Внутрилабораторный контроль качества питатель-
ных сред для автоматического бактериологического анализатора
ЮНОНА® Labstar 50. Клиническая лабораторная диагностика.
2021; 66(2): 110-14. DOI: 10.51620/0869-2084-2021-66-2-110-114.
17. Каргальцева Н.М., Кочеровец В.И., Миронов А.Ю., Борисова О.Ю.
Метод получения гемокультуры при диагностике инфекции кро-
вотока. Клиническая лабораторная диагностика. 2020; 65(3): 185-
90. DOI: 10.18821/0869-2084-2020-65-3-185-190.
30. Попов Д.А., Овсеенко С.Т., Вострикова Т.Ю. Экспресс-иденти-
фикация положительных гемокультур с помощью метода прямой
MALDI-TOF-масс-спектрометрии. Анестезиология и реанимато-
логия. 2015; 60(5): 71-5.
34. Халиулин А.В., Лямин А.В., Гусякова О.А., Козлов А.В., Балди-
на О.А. Способ пробоподготовки для ускоренной идентификации
микроорганизмов из положительных гематологических культур.
Патент РФ № 2766185; 2022.
35. Халиулин А.В. Оценка аналитических характеристик культураль-
ного исследования крови и ускоренной идентификации микроор-
ганизмов при инфекциях кровотока. Иммунопатология, аллерго-
логия, инфектология. 2022; 3: 21-9. DOI: 10.14427/jipai.2022.3.21.
R E F E R E NC E S
1. Jaramillo-Bustamante J.C., Piñeres-Olave B.E., González-
Dambrauskas S. SIRS or not SIRS: Is that the infection? A critical
review of the sepsis definition criteria. Boletin medico del Hospital
Infantil de Mexico. 2020; 77(6): 293-302. DOI: 10.24875/
BMHIM.20000202.
2. Qiu X., Lei Y.P., Zhou R.X. SIRS, SOFA, qSOFA, and NEWS in the
diagnosis of sepsis and prediction of adverse outcomes: a systematic
review and meta-analysis. Expert review of anti-infective therapy.
2023; 21(8): 891–900. DOI: 10.1080/14787210.2023.2237192.
3. Chand S., Kumar N., Mawari G., Sarkar S., Daga M.K., Raghu R.V.
et al. Systemic inflammatory response syndrome criteria (SIRS) and
sepsis 3 criteria for assessing outcomes in sepsis: A prospective observational
study. Lung India: official organ of Indian Chest Society.
2023; 40(3): 200-04. DOI: 10.4103/lungindia.lungindia_400_22.
4. Nguyen P.H., Fay K.A., English J.M., Gill H.S. Serial measurements
of SIRS and SEP scores to identify unique phenotypes of sepsis. Internal
and emergency medicine. 2024; 19(4): 1099–1107. DOI: 10.1007/
s11739-023-03512-4.
5. Rincon T.A., Raffa J., Celi L.A., Badawi O., Johnson A.E.W., Pollard
T. et al. Evaluation of evolving sepsis screening criteria in discriminating
suspected sepsis and mortality among adult patients admitted
to the intensive care unit. International journal of nursing studies.
2023; 145: 104529. DOI: 10.1016/j.ijnurstu.2023.104529.
6. Falagas M.E., Ierodiakonou V., Alexiou V.G. Clinical practice of obtaining
blood cultures from patients with a central venous catheter in
place: an international survey. Clinical microbiology and infection: the
official publication of the European Society of Clinical Microbiology
and Infectious Diseases. 2009; 15(7): 683-6. DOI: 10.1111/j.1469-
0691.2009.02784.x
7. Wen H., Wang W., Xie S., Sun Q., Liang Y., Wen B. et al. Effects
of Blood Culture Aerobic/Anaerobic Bottle Collection Patterns from
Both Sides of the Body on Positive Blood Culture Rate and Time-to-
Positivity. Infection and drug resistance. 2022; 15: 2995–3004. DOI:
10.2147/IDR.S358675.
8. Ombelet S., Natale A., Ronat J.B., Kesteman T., Vandenberg O., Jacobs
J. et al. Biphasic versus monophasic manual blood culture bottles
for low-resource settings: an in-vitro study. The Lancet Microbe.
2022; 3(2): e124–e132. DOI: 10.1016/S2666-5247(21)00241-X.
9. Kutsevalova O.Yu., Kozel Yu.Yu., Alaverdyan A.I., Gusak D.A.
Analysis of the etiology of the structure of bloodstream infections
using the automatic bacteriological analyzer Yunon® Labstar. Klinicheskaya
Laboratornaya Diagnostika. 2022; 67(2): 101-5. DOI:
10.51620/0869-2084-2022-67-2-101-105. (in Russian)
10. Boronina L.G., Samatova E.V., Kukushkina M.P., Panova S.A., Ustyugova
S.S. In-laboratory quality control of nutrients for automatic
bacteriology analyzer YUNON® Labstar 50. Klinicheskaya Laboratornaya
Diagnostika. 2021; 66(2): 110-4. DOI: 10.51620/0869-2084-
2021-66-2-110-114. (in Russian)
11. Ulrich P.S., Bastian I.N., Chen D.J. Clinical Significance of BD
Bactec FX Blood Culture Incubation Beyond 96 Hours (4 Days).
Journal of clinical microbiology. 2022; 60(7): e0054922. DOI:
10.1128/jcm.00549-22.
12. Amano M., Matsumoto M., Sano S., Oyama M., Nagumo H., Watanabe-
Okochi N. et al. Characteristics of False-Positive Alarms in
the BacT/Alert 3D System. Microbiology spectrum. 2022; 10(3):
e0005522. DOI: 10.1128/spectrum.00055-22.
13. Jashari R., Vanzeebroeck S., Petit P., Rodriguez-Villalobos H., Zahra
S., Ben Said N. et al. The BD BACTEC FX blood culture system with
the gentlemacs dissociator is suitable for sterility testing of heart valve
and vascular allografts-A validation study. Cell and tissue banking.
2021; 22(3): 453-66. DOI: 10.1007/s10561-020-09893-6.
14. Udayan U., Dias M. Evaluation of BACTEC™ blood culture system
for culture of normally sterile body fluids. Indian journal of critical
care medicine: peer-reviewed, official publication of Indian Society of
Critical Care Medicine. 2014; 18(12): 829-30. DOI: 10.4103/0972-
5229.146331.
15. Mazzulli T., Ratkov D., Guglielmin K., Gandhi B., Remington R.,
Birch R. et al. Impact of Implementation of BacT/Alert Virtuo on
Blood Culture Time to Positivity in Sepsis Patients. Microbiology
spectrum. 2023; 11(2): e0500322. DOI: 10.1128/spectrum.05003-22
16. Kim S.C., Kim S., Lee D.H., Choi S.R., Kim J.S. Effect of blood
volume in standard anaerobic blood culture bottles of the BacT/
ALERT 3D system used for the detection of pathogens and time to
detection. PLoS One. 2015; 10(2): e0116728. DOI: 10.1371/journal.
pone.0116728.
17. Kargaltseva N.M., Kocherovets V.I., Mironov A.Y., Borisova O.Y.
Method for obtaining a blood culture in the diagnosis of bloodstream
infection. Klinicheskaya laboratornaya diagnostika. 2020; 65(3):
185-90. DOI: 10.18821/0869-2084-2020-65-3-185-190. (in Russian)
18. Bouza E., Sousa D., Rodríguez-Créixems M., Lechuz J.G., Muñoz P.
Is the volume of blood cultured still a significant factor in the diagnosis
of bloodstream infections? Journal of clinical microbiology. 2007;
45(9): 2765-9. DOI: 10.1128/JCM.00140-07.
19. Lee A., Mirrett S., Reller L.B., Weinstein M.P. Detection of bloodstream
infections in adults: how many blood cultures are needed?
Journal of clinical microbiology. 2007; 45(11): 3546-8. DOI: 10.1128/
JCM.01555-07.
20. Ntusi N., Aubin L., Oliver S., Whitelaw A., Mendelson M. Guideline
for the optimal use of blood cultures. South African medical journal
= Suid-Afrikaanse tydskrif vir geneeskunde. 2010; 100(12): 839–43.
DOI: 10.7196/samj.4217
21. Mueller-Premru M., Jeverica S., Papst L., Nagy E. Performance of two
blood culture systems to detect anaerobic bacteria. Is there any difference?
Anaerobe. 2017; 45: 59-64. DOI: 10.1016/j.anaerobe.2017.03.
22. Lovern D., Katzin B., Johnson K., Broadwell D., Miller E., Gates A.
et al. Antimicrobial binding and growth kinetics in BacT/ALERT®
FA Plus and BACTEC® Aerobic/F Plus blood culture media. European
journal of clinical microbiology & infectious diseases: official
publication of the European Society of Clinical Microbiology. 2016;
35(12): 2033-6. DOI: 10.1007/s10096-016-2759-9.
23. Chen I.H., Nicolaou D.P., Kuti J.L. Isolation of Gram-negative bacteria
from aerobic blood culture bottles containing antibiotic binding resins
after exposure to concentrations of β-lactams and fluoroquinolones.
Journal of clinical microbiology. 2019; 57(10): e00849-19. DOI:
10.1128/JCM.00849-19.
24. Flayhart D., Borek A.P., Wakefield T., Dick J., Carroll K.C.
Comparison of BACTEC PLUS blood culture media to BacT/Alert
FA blood culture media for detection of bacterial pathogens in samples
containing therapeutic levels of antibiotics. Journal of clinical
microbiology. 2007; 45(3): 816-21. DOI: 10.1128/JCM.02064-06.
25. Zadroga R., Williams D.N., Gottschall R., Hanson K., Nordberg V.,
Deike M. et al. Comparison of 2 blood culture media shows significant
differences in bacterial recovery for patients on antimicrobial
therapy. Clinical infectious diseases: an official publication of the
Infectious Diseases Society of America. 2013; 56(6): 790-7. DOI:
10.1093/cid/cis1021.
26. Mitteregger D., Barousch W., Nehr M., Kundi M., Zeitlinger M.,
Makristathis A. et al. Neutralization of antimicrobial substances in new
BacT/Alert FA and FN Plus blood culture bottles. Journal of clinical
microbiology. 2013; 51(5): 1534-40. DOI: 10.1128/JCM.00103-13.
27. Mueller-Premru M., Jeverica S., Papst L., Nagy E. Performance
of two blood culture systems to detect anaerobic bacteria. Is there
any difference? Anaerobe. 2017; 45: 59-64. DOI: 10.1016/j.anaerobe.
2017.03.006.
28. Kim S.C., Lee S., Kim S., Cho O.H., Park H., Yu S.M. Comparison of
Clinical Performance Between BacT/Alert Virtuo and BacT/Alert 3D
Blood Culture Systems. Annals of laboratory medicine. 2019; 39(3):
278-83. DOI: 10.3343/alm.2019.39.3.278.
29. Jacobs M.R., Mazzulli T., Hazen K.C., Good C.E., Abdelhamed A.M.,
Lo P. et al. Multicenter Clinical Evaluation of BacT/Alert Virtuo
Blood Culture System. Journal of clinical microbiology. 2017; 55(8):
2413-21. DOI: 10.1128/JCM.00307-17.
30. Totty H., Ullery M., Spontak J., Viray J., Adamik M., Katzin B. et al.
A controlled comparison of the BacT/ALERT®3D and VIRTUO™
microbial detection systems. European journal of clinical microbiology
& infectious diseases: official publication of the European Society
of Clinical Microbiology. 2017; 36(10): 1795-800. DOI: 10.1007/
s10096-017-2994-8.
31. Popov D.A., Ovseenko S.T., Vostrikova T.Yu. Rapid identification of
positive blood cultures using direct MALDI-ToF mass spectrometry.
Anesteziologiya i reanimatologiya. 2015; 60 (5): 71-5. (in Russian)
32. Christner M., Rohde H., Wolters M., Sobottka I., Wegscheider K.,
Aepfelbacher M. Rapid identification of bacteria from positive blood
culture bottles by use of matrix-assisted laser desorption-ionization
time of flight mass spectrometry fingerprinting. Journal of clinical
microbiology. 2010; 48(5): 1584-91. DOI: 10.1128/JCM.01831-09.
33. Jeverica S., Nagy E., Mueller-Premru M., Papst L. Sample preparation
method influences direct identification of anaerobic bacteria from
positive blood culture bottles using MALDI-ToF MS. Anaerobe.
2018; 54: 231-5. DOI: 10.1016/j.anaerobe.2018.05.003.
34. Khaliulin A.V., Lyamin A.V., Gusyakova O.A., Kozlov A.V., Baldina
O.A. Sample preparation method for accelerated identification of
microorganisms from positive hematological cultures. Patent RF №
2766185; 2022. (in Russian)
35. Khaliulin A.V. Evaluation of the analytical characteristics of blood
culture and accelerated identification of microorganisms in bloodstream
infections. Immunopatologiya, allergologiya, infektologiya.
2022; 3: 21-9. DOI: 10.14427/jipai.2022.3.21. (in Russian)
36. Choe K.W., Lim Y.K., Lee M.K. Comparison of new and old BacT/
ALERT aerobic bottles for detection of Candida species. PLoS One.
2023; 18(11): e0288674. DOI: 10.1371/journal.pone.0288674.
37. Birkhamshaw E., Winzor G. Increasing the volume of blood received
in adult paired blood culture bottles at a regional public health
laboratory: results of a quality improvement project to optimise the
diagnosis of bacteraemia. Infection prevention in practice. 2019; 1(1):
100007. DOI: 10.1016/j.infpip.2019.100007.
38. Klingspor L., Muhammed S.A., Ozenci V. Comparison of the two
blood culture systems, Bactec 9240 and BacT/Alert 3D, in the detection
of Candida spp. and bacteria with polymicrobial sepsis. European
journal of clinical microbiology & infectious diseases: official
publication of the European Society of Clinical Microbiology. 2012;
31(11): 2983-7. DOI: 10.1007/s10096-012-1650-6
39. Ye H., Su F.F., Cui X.Y., Guo X.X., Zhu T.Y., Kong D.Y. et al. Evaluation
of Different Blood Culture Bottles for the Diagnosis of Bloodstream
Infections in Patients with HIV. Infectious diseases and therapy.
2023; 12(11): 2611-20. DOI: 10.1007/s40121-023-00883-1.