Problems in Evaluating the Prevalence of Bacteremia in Population Subgroups

In their study, Hyernard et al1 might have made an inaccurate estimate of the prevalence of atypical presentation of bacteremia (and, hence, prognosis), given the fact that they depended solely on blood cultures to validate the diagnosis of that disorder. Blood cultures underestimate the true prevalence of bacteremia because some culprit pathogens are non-cultivable,2 and also because bacteremia may be undetectable by blood culture if the concentration of culprit pathogens has been drastically reduced by prior antibiotic therapy.