Reviews
Vol. 40 No. 1 (2025)
Extended incubation in blood cultures: necessity or nuance?
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 10 July 2025
Accepted: 13 August 2025
Accepted: 13 August 2025
296
Views
99
Downloads
Authors
Bloodstream Infections (BSIs) are severe conditions caused by microbial pathogens that can lead to life-threatening complications if not diagnosed and treated promptly. Blood culture remains the primary method for detecting these infections, allowing clinicians to identify causative organisms and select appropriate antimicrobial therapies. While traditional culture techniques are widely used, their long processing time has driven the adoption of automated systems such as BacT/ALERT and BACTEC, which offer faster and more accurate results. In addition, extending incubation periods has proven valuable in recovering slow-growing bacteria and fungi, particularly those that may be missed within standard time frames. This strategy supports antimicrobial stewardship by reducing reliance on empirical treatments and ensuring targeted antibiotic use. However, there are certain challenges in prolonging the incubation time, including an increased risk of contamination, higher resource demands, and workflow adjustments in laboratories. A critical balance and customisation as per the requirements of the clinicians and the resources of the laboratory are required.
Downloads
Download data is not yet available.
Citations
1. Alahmadi YM, Mcelnay JC, Kearney MP, et al. Tackling the problem of blood culture contamination in the intensive care unit using an educational intervention. Epidemiol Infect 2015;143:1964-71.
2. Berbari EF, Kanj SS, Kowalski TJ, et al. Infectious Diseases Society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clinical Infectious Diseases 2015;61:e26-46.
3. Chela HK, Vasudevan A, Rojas-Moreno C, Naqvi SH. Approach to positive blood cultures in the hospitalized patient: a review. Mo Med 2019;116:313-7.
4. Cockerill FR III, Wilson JW, Vetter EA, et al. Optimal testing parameters for blood cultures. Clinical Infectious Diseases 2004;38:1724-30.
5. Forward KR. An evaluation of extended incubation time with blind subculture of blood cultures in patients with suspected endocarditis. Can J Infect Dis Med Microbiol 2006;17:186-8.
6. Fuller DD, Davis TE, Denys GA, York MK. Evaluation of BACTEC MYCO/F lytic medium for recovery of mycobacteria, fungi, and bacteria from blood. J Clin Microbiol 2001;39:2933-6.
7. Girón-Ortega JA, Fernández-Guerrero R, Arjona MM de O, et al. Antibiotic use and outcome in patients with negative blood cultures, a new target population for antimicrobial stewardship interventions: a prospective multicentre cohort (NO-BACT). Journal of Infection 2024;88:95-102.
8. Gonzalez MD, Chao T, Pettengill MA. Modern blood culture. Clin Lab Med 2020;40:379-92.
9. Hagiya H, Ohnishi K, Maki M, et al. Clinical characteristics of Ochrobactrum anthropi bacteremia. Journal of Clinical Microbiology 2013;51:1330-3.
10. Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006;19:788-802.
11. Liesman RM, Pritt BS, Maleszewski JJ, Patel R. Laboratory diagnosis of infective endocarditis. J Clin Microbiol 2017;55:2599-608.
12. Martinez RM, Wolk DM. Bloodstream Infections. In: Hayden RT, Wolk DM, Carroll KC, Tang YW (eds), Diagnostic Microbiology of the Immunocompromised Host. ASM Press; Washington, USA; 2016. p. 653-89.
13. McHugh J, Saleh OA. Updates in culture-negative endocarditis. Pathogens 2023;12:1027.
14. Nath S, Choudhury B, Borbora S. A comparative study of conventional and automated blood culture system in adult patients. Int J Res Rev 2023;10:653-7.
15. Qin Y, Liao Y, Zhou J, et al. Comparative evaluation of BacT/ALERT VIRTUO and BACTEC FX400 blood culture systems for the detection of bloodstream infections. Microbiol Spectr 13:e01850-24.
16. Shapiro K, Cross SJ, Morton TH, et al. Healthcare-associated infections caused by Mycolicibacterium neoaurum. Emerging Infectious Diseases 2023;29:1516-23.
17. Simner PJ, Doerr KA, Steinmetz LK, Wengenack NL. Mycobacterium and aerobic actinomycete culture: are two medium types and extended incubation times necessary? J Clin Microbiol 2016;54:1089-93.
18. Somily AM, Babay HAH, Torchyan AA, et al. Time-to-detection of bacteria and yeast with the BACTEC FX versus BacT/Alert Virtuo blood culture systems. Ann Saudi Med 2018;38:194-9.
19. Tenderenda A, Łysakowska M, Dargiewicz R, Gawron-Skarbek A. Blood culture contamination: a single general hospital experience of 2-year retrospective study. Int J Environ Res Public Health 2022;19:3009.
20. Thorpe TC, Wilson ML, Turner JE, et al. BacT/Alert: an automated colorimetric microbial detection system. J Clin Microbiol 1990;28:1608-12.
21. Ulrich PS, Bastian IN, Chen DJ. Clinical significance of BD Bactec FX blood culture incubation beyond 96 hours (4 days). J Clin Microbiol 2022;60:e00549-22.
How to Cite
Extended incubation in blood cultures: necessity or nuance?. (2025). Microbiologia Medica, 40(1). https://doi.org/10.4081/mm.2025.14134
Copyright (c) 2025 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Similar Articles
- Loria Bianchi, Zaleida Napoli, Swan Donati, Patrizia Lencioni, Fabiano Santoni, Riccardo Lari, Emergency management in bacterial meningitis and sepsis: application of real time-polymerase chain reaction and FilmArray technology performed directly on cerebrospinal fluid and blood samples , Microbiologia Medica: Vol. 30 No. 2 (2015)
- Anna Camaggi, Rosalba Minisini, Stelvio Tonello, Monia Mantovani, Maria Simona Caroppo, Anna Merlo, Miriam Cordovana, Markus Kostrzewa, Hagen Frickmann, Stefano Andreoni, Same-day identification and genotypic antibiotic resistance testing of Mycobacterium tuberculosis complex and non-tuberculous mycobacteria from positive blood culture bottles – a proof of principle assessment , Microbiologia Medica: Vol. 39 No. 2 (2024)
- Vittorio Panetta, Rita Greco, Sandra Costanzo, Andrea Morello, Angelo Costanzo, Giuseppe Canzano, Elizabethkingia meningosepticum: an emerging nosocomial pathogen in a critical patient with septicaemia , Microbiologia Medica: Vol. 32 No. 1 (2017)
- Maria Vittoria Mauro, Saveria Dodaro, Daniela Perugini, Francesca Greco, Cristina Giraldi, Introduction of Gram negative microrganisms rapid identification and direct susceptibility testing to reduce turnaround time in blood cultures , Microbiologia Medica: Vol. 32 No. 4 (2017)
- Andrea Rocchetti, Fabio Rapallo, Paolo Bottino, Alessandra Mastrazzo, Implementation of satellite blood-culture system in an emergency department: impact of time-to results in sepsis detection , Microbiologia Medica: Vol. 31 No. 2 (2016)
- Lara Scoppapietra, Giuseppina Amarù, Cristina Crocillà, Mara Finotti, Marika Salafia, Alessandra Canevaro, Valentino Granero, Risk factors matter: case report of Y. pseudotuberculosis in obese patient , Microbiologia Medica: Vol. 37 No. 2 (2022)
- Elif Bozcal, Distribution and virulence properties of extra-intestinal pathogenic Escherichia coli in Turkey , Microbiologia Medica: Vol. 31 No. 4 (2016)
- Jari Intra, Roberta M. Sala, Eduardo Beck, Paolo Brambilla, Rapid acquisition and modulation of colistin-resistance by an extensively drug-resistant Acinetobacter baumannii: case report and review of current literature , Microbiologia Medica: Vol. 31 No. 3 (2016)
- Lara Scoppapietra, Alessio Audino, Guido Ricciardelli, Giuseppina Amarù, Maura Millesimo, Cristina Crocillà, Valentino Granero, A fatal rhabdomyolysis with the presence of Bacillus cereus on blood culture: description of a clinical case , Microbiologia Medica: Vol. 39 No. 1 (2024)
- Margherita Scapaticci, Giacomo Fossen, Vittorina Ius, Epidemiology of extended spectrum β-lactamase, AmpC and class A carbapenemases-producing organisms isolated at San Camillo Hospital of Treviso (Italy) between April 2012 and March 2014 , Microbiologia Medica: Vol. 31 No. 1 (2016)
1-10 of 479
Next
You may also start an advanced similarity search for this article.