Hemocultura

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Hemocultura é o exame realizado com o objetivo de isolar e identificar microrganismos patogênicos no sangue de um paciente que se supõe ter uma infecção. É um exame auxiliar relevante, pois seu resultado reflete diretamente na terapêutica.

Relevância 

De acordo com o resultado de hemoculturas positivas são escolhidos os antimicrobianos prescritos para determinado paciente.
O resultado deste exame também é critério diagnóstico para doenças como endocardite. É importante ferramenta diagnóstica de infecções hospitalares.

Indicação para a Colheita

A solicitação de hemoculturas deve ser realizada quando o paciente apresentar um quadro infeccioso. No entanto, não é necessária a coleta de hemoculturas diante de todo e qualquer quadro infecioso. A seguir as indicações de coleta de hemoculturas:
• Suspeita de endocardite
• Sepse
• Infecções hospitalares (antes de iniciar, ou antes, da troca de um esquema de antibióticos).
• Febre de origem indeterminada
• Infecções em pacientes imunodeprimidos (oncológicos, neutropênicos, usuários de corticóide, SIDA)
• Meningites (colher líquor também, sendo este mais importante que as
hemoculturas)
• Pneumonias graves (com insuficiência respiratória, instabilidade hemodinâmica)
• Bacteremia.
Nota: de salientar que a solicitação de hemoculturas deve ser realizada a critério do médico assistente, sendo esta uma descrição das principais indicações deste exame.

Número de Amostras 
Devem ser solicitadas 2 amostras de hemoculturas, coletadas de locais diferentes. A coleta deve ser realizada antes do início da antibioticoterapia, pois a presença de antimicrobianos inibe o crescimento das bactérias.

Apoio Bibliográfico
• Ferraz, C.A. (2010). Rotina de Hemoculturas. Protocolo de Atendimento.

Por: Samuel Manuel

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