Three Clusters of Bacillus Pseudobacteremia Related to a Radiometric Blood Culture Analyzer

1984 ◽  
Vol 5 (2) ◽  
pp. 71-74 ◽  
Author(s):  
Inge Gurevich ◽  
Patricia Tafuro ◽  
Sharon P. Krystofiak ◽  
Robert D. Kalter ◽  
Burke A. Cunha
Keyword(s):  
Blood Culture ◽  
Clinical Signs ◽  
Blood Cultures ◽  
Bacillus Species ◽  
Common Source ◽  
Air Conditioner ◽  
Close Proximity ◽  
Bacillus Spp ◽  
Multiple Blood ◽  
Bacillus Spores

AbstractDuring a ten-month period from September 1981 to July 1982 three episodes of pseudobacteremia due to Bacillus species occurred at this 550-bed institution. The first involved eight isolates, the second 11, and the third seven isolates of the organism, all with the same antibiogram.The patients involved did not exhibit clinical signs of septicemia, and in only one case was more than one specimen per patient positive when multiple blood samples were obtained. Occasional blood cultures of Bacillus species identified in between clusters revealed a different antibiogram.Extensive epidemiologic investigation of patient locations, phlebotomists, and time of cultures yielded no common source. Components involved in the transport and processing of blood cultures, including the radiometric blood culture processor, were also sampled but without recovery of the organism. After the last episode, a layer of dust was noted inside the machine, and culture of this dust grew Bacillus spp. with the same antibiogram as those found in the blood cultures. The filter from an air conditioning unit in close proximity to the machine grew several species of Bacillus.It is presumed that Bacillus spores in the dust were introduced into the blood culture bottles following the heat sterilization of the gas sampling (inoculation/removal) needles.Modification of the cover of the machine was undertaken to prevent access of dust bearing microbes to the inside of the machine. In addition, maintenance now includes regular disinfection/cleaning of the “floor” of the machine, and more frequent changes of the air conditioner filter.

scholarly journals Molecular epidemiology of catheter-related bloodstream infections caused by coagulase-negative staphylococci in haematological patients with neutropenia

2004 ◽  
Vol 132 (5) ◽  
pp. 921-925 ◽  
Author(s):  
M. MÜLLER-PREMRU ◽  
P. ČERNELČ
Keyword(s):  
Blood Culture ◽  
Staphylococcus Epidermidis ◽  
Clinical Signs ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Blood Cultures ◽  
Peripheral Vein ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Haematological Patients

Catheter-related bloodstream infection (CRBSI) caused by coagulase-negative staphylococci (CNS) is common in haematological patients with febrile neutropenia. As the clinical signs of CRBSI are usually scarce and it is difficult to differentiate from blood culture contamination, we tried to confirm CRBSI by molecular typing of CNS isolated from paired blood cultures (one from a peripheral vein and another from the central venous catheter hub). Blood cultures were positive in 59 (36%) out of 163 patients. CNS were isolated in 24 (40%) patients; in 14 from paired blood cultures (28 isolates) and in 10 from a single blood culture. CNS from paired blood cultures were identified as Staphylococcus epidermidis. Antimicrobial susceptibility was determined and bacteria were typed by pulsed-field gel electrophoresis (PFGE) of bacterial genomic DNA. In 13 patients, the antibiotic susceptibility of isolates was identical. The PFGE patterns from paired blood cultures were identical or closely related in 10 patients, thus confirming the presence of CRBSI. In the remaining four patients they were unrelated, and suggested a mixed infection or contamination. Since CNS isolates from three patients had identical PFGE patterns, they were probably nosocomially spread amongst them.

Blood Culture Contamination in the Clinical Microbiology Laboratory of a Teaching Hospital

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S133-S133
Author(s):  
Kemin Xu ◽  
Sarwat Gilani ◽  
Hank Wang ◽  
John Fallon
Keyword(s):  
Blood Culture ◽  
Teaching Hospital ◽  
Clinical Microbiology ◽  
Diagnostic Errors ◽  
Blood Cultures ◽  
Bacillus Species ◽  
Contamination Rate ◽  
Clinical Microbiology Laboratory ◽  
Current Guideline ◽  
Tertiary Teaching

Abstract Objectives Blood culture is one of the most important tests performed in clinical microbiology laboratories. However, blood culture contamination remains a problematic cause of diagnostic errors for laboratory diagnosis and patient management. This aim of this study was to determine blood culture contamination rates and tendency at Westchester Medical Center (WMC), a tertiary teaching hospital in suburban New York City. Methods All blood culture tests at WMC received from January 2017 to December 2018, as well as some historical data from 2007 to 2014, were retrospectively retrieved. Blood culture contamination rates were determined according to the laboratory’s predefined criteria. Results From 2007 to 2014, a total of 209,750 blood cultures were performed with an average contamination rate of 1.6% (ranging from 0.4% to 3.5% monthly). The total numbers of blood cultures performed in 2017 and 2018 were 27,863 and 28,047, respectively. The overall positive rate of blood culture was 6.8% in 2017 and 7.6% in 2018. The contamination rate of blood culture was 0.6% in 2017 and 0.9% in 2018 with very few variations among different months of the year, which was significantly lower than that of the national benchmark (~2.5%) on blood culture contamination. The majority of contaminants were Staphylococcus epidermidis, accounting for 87% of source contamination, followed by Corynebacterium species (5.5%), Bacillus species and Micrococcus species (3.5% each), and Propionibacterium species (0.5%). Conclusion Adherence to current guideline on appropriate blood collection techniques and monthly monitoring and timely feedback to phlebotomists should be continued to keep a low contamination rate for blood culture, which is not only from the perspective of individual patient care but also from the standpoint of hospital epidemiology and public health.

scholarly journals Two Blood Cultures With Age-Appropriate Volume Enhance Suspected Sepsis Decision-Making

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Paul Tran ◽  
Elaine Dowell ◽  
Stacey Hamilton ◽  
Susan A Dolan ◽  
Kevin Messacar ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Decision ◽  
Antimicrobial Treatment ◽  
Blood Cultures ◽  
Antibiotic Administration ◽  
Suspected Sepsis ◽  
Number Of Children ◽  
Before And After ◽  
Age Appropriate ◽  
Multiple Blood

Abstract Background Multiple blood cultures have been shown to improve pathogen yield and antimicrobial stewardship for adult patients with suspected serious bacterial infection (SBI). For children, the use of multiple blood cultures is less common and volume recommendations are more complicated, often resulting in single cultures with low volume. Methods In 2010, Children’s Hospital Colorado instituted electronic medical record (EMR) decision support to recommend collection of 2 blood cultures before administration of antibiotics for suspected SBI. Recommended blood culture volumes were calculated by age rather than weight. We evaluated all children admitted to inpatient units between 2008 and 2009 (pre-intervention) and 2011 and 2013 (postintervention) who received antibiotics in the hospital after having blood cultures drawn in the emergency department, excluding those with a length of stay >8 days. We compared blood culture yield, isolate classification (pathogen vs contaminant), and antimicrobial modifications before and after the interventions. Results A total of 3948 children were included in the study. EMR guidelines were associated with a significantly higher number of children with multiple blood cultures drawn before antibiotic administration (88.0% vs 12.3%; P < .001) and an increased percentage of blood cultures with the recommended volume (74.3% vs 15.2%; P < .001), resulting in a significantly higher pathogen isolation rate and improved antimicrobial decisions. Multiple cultures helped define the role of common contaminants in the clinical decision process. Conclusions Multiple blood cultures with age-based volumes taken before starting antibiotics increase pathogen isolation rates and appropriate modification of antimicrobial treatment in children.

DETECTION AND DIFFERENTIATION OF SPORE AND VEGETATIVE FORMS OF BACILLUS SPP. USING INFRARED SPECTROSCOPIC METHODS

2008 ◽  
Vol 18 (02) ◽  
pp. 417-427
Author(s):  
DIANE ST. AMANT ◽  
MARK CAMPBELL ◽  
ANDREW BECK ◽  
LESLIE WILLIAMS ◽  
JENNIFER MINTER ◽  
...  
Keyword(s):  
Thin Film ◽  
Infrared Spectroscopy ◽  
Attenuated Total Reflection ◽  
Bacillus Species ◽  
Infrared Spectrometry ◽  
Limited Information ◽  
Transmission Method ◽  
Vegetative Cells ◽  
Bacillus Spp ◽  
Bacillus Spores

Infrared spectroscopy has been demonstrated as a powerful tool for taxonomic classification of bacteria when the microbes are grown and sampled under carefully controlled conditions. Infrared spectroscopy affords limited information about relative proportions of certain chemical functional groups in whole microbial cells. The objective of this work is to elucidate the ability of infrared spectroscopy to identify and speciate Bacillus spp. regardless of sample history. Spectrometers utilize different scanning methods to collect infrared absorption spectra. We employed three; transmission through a thin film, transmission infrared microscopy, and Attenuated Total Reflection (ATR). Target organisms include Bacillus anthracis, and several near neighbors. Each strain was cultured at 24°C and 35°C on three solid media. Microorganisms were incubated for up to ten days to include vegetative cells, spore formation and mature spores. Triplicate microbe samples were prepared and analyzed according to instrument requirements using the three measurement modes. Triplicate samples of BSL-3 organisms were analyzed only by the thin film transmission method. Spectral data was analyzed using the cluster analysis function of OPUS software. We report that infrared spectrometry is capable of discerning Bacillus spores from vegetative cells and the phylogenic clustering of Bacillus species according to pathogenicity levels via infrared spectral analysis.

scholarly journals G-control Charts for Contamination Rates of Blood Cultures in a University Hospital

2021 ◽  
Vol 73 (6) ◽  
pp. 406-412
Author(s):  
Tharntip Sangsuwan ◽  
Rungtip Darayon ◽  
Silom Jamulitrat
Keyword(s):  
Blood Culture ◽  
Control Charts ◽  
Blood Cultures ◽  
University Hospital ◽  
Contamination Rate ◽  
Control And Prevention ◽  
Bacillus Spp ◽  
Neonatal Icu ◽  
Pediatric Icu ◽  
Contamination Events

Objective: To determine blood culture contamination rates, and display with a g-chart.Materials and Methods: The medical records of patients, from whom blood cultures were obtained in a university hospital, during January and December 2019 were retrieved and reviewed for contamination. The Center for Disease Control and Prevention (CDC) criteria were used to classify the blood culture results. The contamination rates were illustrated with a g-chart.Results: We identified 331 false-positive blood cultures, among 32,961 cultured specimens; yielding a contamination rate of 1.0% (95%CI = 0.9% – 1.1%). The highest contamination events occurred in the Emergency department (49.2%), Pediatric ICU (5.2%) and Neonatal ICU (4.8%), respectively. The most common commensal bacterial genus were Staphylococcus coagulase negative (67.1%), Bacillus spp. (10.2%) and Corynebacterium spp. (7.6%), correspondingly. The g-charts could identify 14 abnormal variations, in 41 locations.Conclusion: The contamination rates found were within ranges of other reports. G-charts are simple to construct, easy to interpret and sensitive for detection of real time epidemics.

scholarly journals Environmental Drivers of Bacillus-Positive Blood Cultures in a Cancer Hospital, Sapporo, Japan

2018 ◽  
Vol 15 (10) ◽  
pp. 2201 ◽  
Author(s):  
Takahiro Fujita ◽  
Hiroshi Nishiura
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Characteristic Curve ◽  
Time Lag ◽  
Absolute Humidity ◽  
Blood Cultures ◽  
Japan Meteorological Agency ◽  
Environmental Drivers ◽  
Bacillus Species ◽  
Important Message

The Bacillus species is a well-documented causative pathogen of nosocomial bloodstream infection. The present study aimed to identify climatological variables that are associated with Bacillus-positive blood culture in Sapporo, Japan. All cases with Bacillus-positive blood cultures from January 2011 to December 2016 were retrospectively analysed. Climatological data from 2011 to 2016, including daily mean temperature and absolute humidity, were retrieved from the Japan Meteorological Agency. Employing a hazard-based statistical model to describe the non-homogeneous counting process in which temperature and absolute humidity act as explanatory variables, we computed all possible models with variable lengths of time lag. Akaike Information Criterion was computed to identify the best fitted model. High wavelet power at 12 months was identified for the period from 2013 onwards, which coincided with the time period in which sampling multiple sets of blood culture has been recommended. The temperature-only model with a lag of six days yielded a high sensitivity value (72.1%) and appeared to be the optimal model to predict Bacillus-positive blood culture with the highest area under the receiver operating characteristic curve value. Temperature was identified as a climatological driver of Bacillus-positive blood culture. Our statistical modelling exercise offers an important message for infection control practices to improve awareness among healthcare workers of the identified association and mechanically controlled in-room temperature.

scholarly journals Time to blood cultures positivity of microorganisms using a continuous-monitoring automated blood cultures system

2019 ◽  
Vol 13 (2) ◽  
pp. 61-69
Author(s):  
Pajaree Krisanapan ◽  
Romanee Chaiwarith
Keyword(s):  
Blood Culture ◽  
Continuous Monitoring ◽  
Hematologic Malignancy ◽  
Cross Sectional Study ◽  
Blood Cultures ◽  
Common Source ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Blood Culture Positivity ◽  
Clinically Significant

Abstract Background Previous studies showed that clinically significant pathogens were detected within 3 days of incubation using a continuous monitoring automated blood culture instrument. Objectives To determine time to blood culture positivity (TTP) of microorganisms using a BD BACTEC™ FX. Methods A cross-sectional study was conducted at Maharaj Nakorn Chiang Mai Hospital, Thailand from October to November 2014. Results One-hundred and eighty-one patients with 195 episodes of infection and 436 cultures were included in the analysis. Among 181 patients, 55.2% were male and the median age was 61 years (interquartile range (IQR) 50, 76). Of the 195 episodes of infections, the most common source was genitourinary tract (15.4%). Overall, the median TTP was 17 hours (IQR 11.5, 24.5), the shortest TTP was observed in Streptococcus agalactiae. Four-hundred and seventy-eight cultures (97.6%) and all (100%) were detected at 3 days and 5 days of incubation. Factors associated with TTP ≤24 hour were blood drawn from patients who had hematologic malignancy (odds ratio (OR) 9.6, 95% confidence interval (CI) 1.2, 74.3, P = 0.030), endocarditis and vascular infection (OR 8.7, 95% CI 1.1, 67.2, P = 0.038), thrombocytopenia (OR 2.4, 95% CI 1.3, 4.4, P = 0.004), clinical of systemic inflammatory response syndrome (SIRS) (OR 2.3, 95% CI 1.2, 4.5, P = 0.014), and not receiving antimicrobials within 72 hours before cultures taken (OR 2.2, 95% CI 1.4, 3.6, P < 0.001). Conclusions TTP varied depends upon the pathogens and clinical settings. However, bacteria were isolated from almost, but not all of the blood cultures within 3 days of incubation.

scholarly journals Hematologic Parameters and Blood Cultures from the Gingival Vein Compared with the Cranial Vena Cava in Guinea Pigs

2019 ◽  
Vol 58 (6) ◽  
pp. 817-822
Author(s):  
Alexa R Personett ◽  
Kelly S Santangelo ◽  
Lon V Kendall ◽  
Miranda J Sadar
Keyword(s):  
Guinea Pigs ◽  
Sampling Site ◽  
Vena Cava ◽  
Clinical Signs ◽  
Sampling Technique ◽  
Blood Cultures ◽  
Blood Collection ◽  
Blood Samples ◽  
Multiple Blood ◽  
Collection Methods

Blood collection methods in guinea pigs are limited due to the animals' compact neck, short limbs, and lack of a tail. Gingival venipuncture is a recently described blood sampling technique that is minimally traumatic with no significant alterations in hematologic parameters when multiple blood samples were collected weekly for 6 wk. The purpose of this study was to determine whether the gingival vein can be used as an alternative blood collection site in guinea pigs, such that: (1) hematologic parameters would be consistent with samples collected from the cranial vena cava; and (2) no contaminants from the oral cavity would be introduced into the sample. Blood samples were obtained from both the gingival vein and cranial vena cava of anesthetized Dunkin Hartley guinea pigs for CBC (n = 9) and aerobic blood cultures (n = 10). Only MCV was significantly different between sampling sites. Bland–Altman analyses calculated a small mean bias for all hematologic parameters, indicating clinical interpretation is unlikely to be affected by the sampling site. Bacterial growth occurred in all 5 gingival vein blood samples prepared by using saline and 2 of the 5 prepared with dilute chlorhexidine. Bacteria did not grow from any cranial vena caval blood samples prepared with dilute chlorhexidine. No clinical signs of hemorrhage or trauma were detected at either site. These results provide evidence that gingival venipuncture can be used as an alternative blood collection method for guinea pigs for hematologic analysis but should not be used for blood culture.

scholarly journals Epidemiology of Blood Culture Utilization in a Cohort of Critically Ill Children

2019 ◽  
Vol 08 (03) ◽  
pp. 144-147
Author(s):  
Christine Anh-Thu Tran ◽  
Jenna Verena Zschaebitz ◽  
Michael Campbell Spaeder
Keyword(s):  
Decision Making ◽  
Blood Culture ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Critically Ill ◽  
Clinical Status ◽  
Blood Cultures ◽  
Systemic Inflammatory Response ◽  
Critically Ill Children ◽  
Culture Acquisition

AbstractBlood culture acquisition is integral in the assessment of patients with sepsis, though there exists a lack of clarity relating to clinical states that warrant acquisition. We investigated the clinical status of critically ill children in the timeframe proximate to acquisition of blood cultures. The associated rates of systemic inflammatory response syndrome (72%) and sepsis (57%) with blood culture acquisition were relatively low suggesting a potential overutilization of blood cultures. Efforts are needed to improve decision making at the time that acquisition of blood cultures is under consideration and promote percutaneous blood draws over indwelling lines.

scholarly journals Diagnostic Value of Clinical Features to Distinguish Enteric Fever From Other Febrile Illnesses in Bangladesh, Nepal, and Pakistan

2020 ◽  
Vol 71 (Supplement_3) ◽  
pp. S257-S265 ◽  
Author(s):  
Kristen Aiemjoy ◽  
Dipesh Tamrakar ◽  
Shampa Saha ◽  
Shiva R Naga ◽  
Alexander T Yu ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Features ◽  
Diagnostic Performance ◽  
Enteric Fever ◽  
Random Effect ◽  
Clinical Signs ◽  
Febrile Illness ◽  
Diagnostic Value ◽  
Case Definition ◽  
Mixed Effect

Abstract Background Enteric fever, a bacterial infection caused by Salmonella enterica serotypes Typhi and Paratyphi A, frequently presents as a nonlocalizing febrile illness that is difficult to distinguish from other infectious causes of fever. Blood culture is not widely available in endemic settings and, even when available, results can take up to 5 days. We evaluated the diagnostic performance of clinical features, including both reported symptoms and clinical signs, of enteric fever among patients participating in the Surveillance for Enteric Fever in Asia Project (SEAP), a 3-year surveillance study in Bangladesh, Nepal, and Pakistan. Methods Outpatients presenting with ≥3 consecutive days of reported fever and inpatients with clinically suspected enteric fever from all 6 SEAP study hospitals were eligible to participate. We evaluated the diagnostic performance of select clinical features against blood culture results among outpatients using mixed-effect regression models with a random effect for study site hospital. We also compared the clinical features of S. Typhi to S. Paratyphi A among both outpatients and inpatients. Results We enrolled 20 899 outpatients, of whom 2116 (10.1%) had positive blood cultures for S. Typhi and 297 (1.4%) had positive cultures for S. Paratyphi A. The sensitivity of absence of cough was the highest among all evaluated features, at 65.5% (95% confidence interval [CI], 55.0–74.7), followed by measured fever at presentation at 59.0% (95% CI, 51.6–65.9) and being unable to complete normal activities for 3 or more days at 51.0% (95% CI, 23.8–77.6). A combined case definition of 3 or more consecutive days of reported fever and 1 or more of the following (a) either the absence of cough, (b) fever at presentation, or (c) 3 or more consecutive days of being unable to conduct usual activity--yielded a sensitivity of 94.6% (95% CI, 93.4–95.5) and specificity of 13.6% (95% CI, 9.8–17.5). Conclusions Clinical features do not accurately distinguish blood culture–confirmed enteric fever from other febrile syndromes. Rapid, affordable, and accurate diagnostics are urgently needed, particularly in settings with limited or no blood culture capacity.

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