scholarly journals Real-world Time to Positivity of 2 Widely Used Commercial Blood Culture Systems in Patients With Severe Manifestations of Sepsis: An Analysis of the FABLED Study

2020 ◽  
Vol 7 (9) ◽  
Author(s):  
Guillaume Butler-Laporte ◽  
Cedric P Yansouni ◽  
Katryn Paquette ◽  
Alexander Lawandi ◽  
Sarah N Stabler ◽  
...  
Keyword(s):  
Blood Culture ◽  
Prospective Study ◽  
Bacterial Species ◽  
Blood Cultures ◽  
Study Cohort ◽  
Analytical Methodology ◽  
Multi Centre Study ◽  
Clinical Sensitivity ◽  
Culture Systems ◽  
Time To Positivity

Abstract Background Of all microbiological tests performed, blood cultures have the most impact on patient care. Timely results are essential, especially in the management of sepsis. While there are multiple available blood culture systems on the market, they have never been compared in a prospective study in a critically ill population. Methods We performed an analysis of the FABLED study cohort to compare culture results and time to positivity (TTP) of 2 widely used blood culture systems: BacT/Alert and BACTEC. In this multisite prospective study, patients with severe manifestations of sepsis had cultures drawn before antibiotics using systematic enrollment criteria and blood drawing methodology allowing for minimization of pre-analytical biases. Results We enrolled 315 patients; 144 had blood cultures (47 positive) with BacT/Alert and 171 with BACTEC (53 positive). Patients whose blood cultures were processed using the BacT/Alert system were younger (median, 64 vs 70 years; P = .003), had a higher proportion of HIV (9.03% vs 1.75%; P = .008) and a lower qSOFA (P = .003). There were no statistically significant differences in the most commonly identified bacterial species. TTP was shorter for BACTEC (median [interquartile range {IQR}], 12.5 [10–14] hours) compared with BacT/Alert (median [IQR], 17 [14–21] hours; P < .0001). Conclusions In this large prospective multi-centre study comparing the two blood culture systems among patients with severe manifestations of sepsis, and using a rigorous pre-analytical methodology, the BACTEC system yielded positive culture results 4.5 hours earlier than BacT/Alert. These results apply to commonly isolated bacteria. However, our study design did not allow direct comparison of TTP for unusual pathogens nor of clinical sensitivity between systems. More research is needed to determine the clinical implications of this finding.

scholarly journals Comparison of microorganism detection and time-to-positivity in pediatric and standard media from three major commercial continuously monitored blood culture systems

2021 ◽  
Author(s):  
Melanie L. Yarbrough ◽  
Meghan A. Wallace ◽  
Carey-Ann D. Burnham
Keyword(s):  
Blood Culture ◽  
Detection Rate ◽  
Culture Media ◽  
Blood Cultures ◽  
Kingella Kingae ◽  
Packed Red Blood Cells ◽  
Culture Systems ◽  
Time To Positivity ◽  
Species Specific ◽  
Blood Volumes

New blood culture instrumentation and media formulations have led to improved time-to-positivity (TTP) for positive blood cultures. Data regarding the necessity of pediatric blood culture bottles with contemporary blood culture systems are sparse. We compared performance of three commercial blood culture systems, evaluating impact of blood volumes in standard and pediatric blood culture media across systems. Simulated blood cultures with packed red blood cells and three Gram-positive, four Gram-negative, and one anaerobic organism (final concentrations ranging from 0.5-19 CFU/mL blood) on the VIRTUO, VersaTREK, and Bactec FX were evaluated with FAN Plus, REDOX, and BACTEC Plus media, respectively. For each media/instrument/organism combination 1, 3, 5, and 10 mL blood volumes were evaluated in triplicate. Detection rate was not affected by blood volume. Aerobic organisms that demonstrated variable detection were Kingella kingae, Haemophilus influenzae and Neisseria meningitidis. Bacteroides fragilis was detected in 83%, 100%, and 100% of VIRTUO, VersaTREK, and Bactec anaerobic bottles. Average TTP of standard media for aerobic organisms detected on VIRTUO was decreased compared to VersaTREK (-2.3 h) and Bactec (-4.9 h). Compared to standard media, detection rate and TTP was unchanged on VIRTUO, while TTP was reduced with pediatric media for 2/8 organisms tested on Bactec and 7/8 organisms on VersaTREK, illustrating the potential benefit of pediatric media on VersaTREK or BACTEC when low blood volumes (<5 mL) are collected. These results demonstrate that TTP is decreased on the VIRTUO compared to VersaTREK and Bactec for many microorganisms associated with BSI but may have species-specific limitations.

scholarly journals Neither Blood Culture Positivity nor Time to Positivity is Associated with Mortality among Patients Presenting with Severe Manifestations of Sepsis: The FABLED Cohort Study

2021 ◽  
Author(s):  
Katryn Paquette ◽  
David Sweet ◽  
Robert Stenstrom ◽  
Sarah N Stabler ◽  
Alexander Lawandi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Blood Culture ◽  
Blood Cultures ◽  
Cell Counts ◽  
Culture Positivity ◽  
Time To Positivity ◽  
Blood Culture Positivity ◽  
Normal White Blood Cell ◽  
Support Fund

Abstract Background Sepsis is a leading cause of morbidity, mortality, and health care costs worldwide. Methods We conducted a multi-center, prospective cohort study evaluating the yield of blood cultures drawn before and after empiric antimicrobial administration among adults presenting to the emergency department with severe manifestations of sepsis (ClinicalTrials.gov: NCT01867905). Enrolled patients who had the requisite blood cultures drawn were followed for 90 days. We explored the independent association between blood culture positivity and its time to positivity in relation to 90-day mortality. Findings 325 participants were enrolled; 90-day mortality among the 315 subjects followed-up was 25·4% (80/315). Mortality was associated with age (mean age in those who died was 72·5 ±15·8 vs. 62·9 ±17·7 years among survivors, p&lt;0·0001), greater Charlson Comorbidity Index (2 (IQR 1,3) vs. 1 (IQR 0,3), p=0·008), dementia (13/80 (16·2%) vs. 18/235 (7·7%), p=0·03), cancer (27/80 (33·8%) vs. 47/235 (20·0%), p=0·015), positive qSOFA score (57/80 (71·2%) vs. 129/235 (54·9%), p=0·009), and normal white blood cell counts (25/80 (31·2%) vs. 42/235 (17·9%), p=0·02). The presence of bacteremia, persistent bacteremia after antimicrobial infusion, and shorter time to blood culture positivity were not associated with mortality. Neither the source of infection nor pathogen affected mortality. Interpretation Although severe sepsis is an inflammatory condition triggered by infection, its 90-day survival is not influenced by blood culture positivity nor its time to positivity. Funding Vancouver Coastal Health; St-Paul’s Hospital Foundation Emergency Department Support Fund; the Fonds de Recherche Santé – Québec (CPY); Intramural Research Program of the NIH, Clinical Center (AL); the Maricopa Medical Foundation

Use of simulated blood cultures for time to detection comparison between BacT/ALERT™ and BACTEC™ 9240 blood culture systems

2002 ◽  
Vol 44 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Egidio Francesco Viganò ◽  
Emanuela Vasconi ◽  
Carlo Agrappi ◽  
Pierangelo Clerici
Keyword(s):  
Blood Culture ◽  
Blood Cultures ◽  
Culture Systems ◽  
Time To Detection

scholarly journals Comparative study of manual conventional blood cultures versus automated blood culture system in cases of septicemia

2021 ◽  
Vol 8 (4) ◽  
pp. 327-332
Author(s):  
Humera Qudsia Fatima Ansari ◽  
Lubna Saher ◽  
Mustafa Afzal
Keyword(s):  
Blood Culture ◽  
Culture System ◽  
Blood Cultures ◽  
Diffusion Method ◽  
Suspected Case ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Gold Standard Method ◽  
Blood Culture System ◽  
Culture Systems

: Blood cultures are a proven gold standard method for the identification of causative agents of bloodstream infections. Identification of causative organism along with antibiotic susceptibility plays a pivotal role in proposing suitable antibiotic therapy. Automated blood culture systems show improved monitoring of blood cultures by reducing the time and by ensuring more accurate results when compared to the conventional blood culture system. To isolate the organism from given blood samples of a suspected case of septicemia and to compare the results of conventional and automated blood culture systems and to study the antimicrobial susceptibility pattern of the pathogens isolated. A prospective study of 6 months period was conducted among 100 subjects attending the Department of Microbiology in a tertiary care hospital. Subjects with symptoms and signs of septicemia were included. 25ml of venous blood was drawn aseptically from the venipuncture site, of which 5ml of blood was inoculated into 50ml of Brain Heart Infusion bottle in conventional blood culture system and 10ml each into aerobic and anaerobic BACTEC PLUS bottle in Automated blood culture system BACTEC FX40. Overall, 48% and 60% of the samples revealed positive growth by the conventional and automated blood culture system BACTEC FX40, respectively. Gram Positive Cocci were 52.08% and Gram Negative Bacilli were 47.91% isolated by conventional blood culture system, whereas automated blood culture system BACTEC FX40 isolated 45% and 55%, respectively. Isolates were detected within 24-48hrs and 12-24 hrs by conventional and automated blood culture systems, respectively. The anti-microbial susceptibility pattern of the pathogens isolated was also recorded by Kirby Bauer disc diffusion method of antimicrobial susceptiblity testing. Automated blood culture systems are a trustworthy substitute to conventional blood culture systems. The automated blood culture systems being more sensitive and rapid in detecting septicemia in subjects acts as an appropriate means for the initial identification and detection of blood pathogens and improved provision of antimicrobial therapeutic options for septic Patients especially in Critical Care and Intensive Care Units where positive culture reporting is crucial.

scholarly journals Impact of delays to incubation and storage temperature on blood culture results: a multi-centre study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clare L. Ling ◽  
Tamalee Roberts ◽  
Sona Soeng ◽  
Tomas-Paul Cusack ◽  
David A. B. Dance ◽  
...  
Keyword(s):  
Blood Culture ◽  
Storage Temperature ◽  
Storage Conditions ◽  
Significant Loss ◽  
Blood Cultures ◽  
Multi Centre Study ◽  
Middle Income ◽  
Ambient Temperatures ◽  
Different Temperatures ◽  
Pathogen Recovery

Abstract Background Blood cultures are one of the most important tests performed by microbiology laboratories. Many hospitals, particularly in low and middle-income countries, lack either microbiology services or staff to provide 24 h services resulting in delays to blood culture incubation. There is insufficient guidance on how to transport/store blood cultures if delays before incubation are unavoidable, particularly if ambient temperatures are high. This study set out to address this knowledge gap. Methods In three South East Asian countries, four different blood culture systems (two manual and two automated) were used to test blood cultures spiked with five common bacterial pathogens. Prior to incubation the spiked blood culture bottles were stored at different temperatures (25 °C, in a cool-box at ambient temperature, or at 40 °C) for different lengths of time (0 h, 6 h, 12 h or 24 h). The impacts of these different storage conditions on positive blood culture yield and on time to positivity were examined. Results There was no significant loss in yield when blood cultures were stored < 24 h at 25 °C, however, storage for 24 h at 40 °C decreased yields and longer storage times increased times to detection. Conclusion Blood cultures should be incubated with minimal delay to maximize pathogen recovery and timely result reporting, however, this study provides some reassurance that unavoidable delays can be managed to minimize negative impacts. If delays to incubation ≥ 12 h are unavoidable, transportation at a temperature not exceeding 25 °C, and blind sub-cultures prior to incubation should be considered.

P935 Time-to-positivity of aerobic blood cultures by using BacTec 9120 blood culture system

2007 ◽  
Vol 29 ◽  
pp. S244-S245
Author(s):  
St. Fokas ◽  
Sp. Fokas ◽  
G. Altouvas ◽  
M. Tsironi ◽  
S. Kaptanis ◽  
...  
Keyword(s):  
Blood Culture ◽  
Culture System ◽  
Blood Cultures ◽  
Blood Culture System ◽  
Time To Positivity

scholarly journals Assessment of clinical profile, antibiotic sensitivity and prescription pattern in blood culture positive enteric fever among pediatric and adult patients admitted in a tertiary care hospital: a prospective study

2019 ◽  
Vol 7 (9) ◽  
pp. 3270
Author(s):  
Swapnil Gautam ◽  
Suraj Purushothaman ◽  
Kinjal P. Patel ◽  
Ajay P. Sankhe ◽  
Madhuri R. Mahadik
Keyword(s):  
Blood Culture ◽  
Prospective Study ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Blood Cultures ◽  
Care Hospital ◽  
Prescription Pattern

Background: Asterion Introduction: Enteric fever is a major concern in developing country. It is predominantly caused by serovars typhi and paratyphi of Salmonella enterica. Recently, an upsurge in antimicrobial resistant strains has worsened the management of enteric fever. So, aim of present study is to evaluate the clinical profile, antibiotic sensitivity and prescription pattern in blood culture proven cases of enteric fever in pediatric and adult patients.Methods: Single centre, prospective study was conducted at a tertiary care hospital. Demographic and clinical details of blood culture proven enteric fever admitted in hospital were collected over the period from August 2016 to November 2018.Results: Total 58 blood cultures grew Salmonella spp. , amongst them 84.48 % had growth of Salmonella typhi. Blood culture was sent after a mean period of 9 days and 10 days of fever in pediatric and adult patients respectively. All isolates of S. paratyphi A were pansusceptible, whereas 36.73 % isolates of S. typhi were multidrug resistant and nalidixic acid resistant. 68.97% patients received antibiotics before admission. The difference between mean time to defervescence in patients who received ceftriaxone and those who received more than one antibiotic was not statistically significant. (P value 0.87)Conclusion: Blood cultures are the important diagnostic tool to identify multidrug resistant Salmonellae. Study showed that combination therapy was not statistically superior and awareness of local antimicrobial susceptibility pattern significantly helps for better management of the patients.

scholarly journals Antibiotic Discontinuation 24 h After Neonatal Late-Onset Sepsis Work-Up—A Validated Decision Tree Model

2021 ◽  
Vol 9 ◽  
Author(s):  
Ori Goldberg ◽  
Nir Sokolover ◽  
Ruben Bromiker ◽  
Nofar Amitai ◽  
Gabriel Chodick ◽  
...  
Keyword(s):  
Blood Culture ◽  
Decision Tree ◽  
Late Onset ◽  
Blood Cultures ◽  
Decision Tree Model ◽  
Study Cohort ◽  
Tree Model ◽  
Interaction Detection ◽  
Late Onset Sepsis ◽  
Work Up

Objectives: Neonatal late-onset sepsis work-up is a frequent occurrence in every neonatal department. Blood cultures are the diagnostic gold standard, however, a negative culture prior to 48–72 h is often considered insufficient to exclude sepsis. We aimed to develop a decision tree which would enable exclusion of late-onset sepsis within 24 h using clinical and laboratory variables.Study Design: Infants evaluated for late-onset sepsis during the years 2016–2019, without major malformations, in a tertiary neonatal center were eligible for inclusion. Blood cultures and clinical and laboratory data were extracted at 0 and 24 h after sepsis work-up. Infants with bacteriologically confirmed late-onset sepsis were compared to matched control infants. Univariate logistic regression identified potential risk factors. A decision tree based on Chi-square automatic interaction detection methodology was developed and validated.Results: The study cohort was divided to a development cohort (105 patients) and a validation cohort (60 patients). At 24 h after initial evaluation, the best variables to identify sepsis were C-reactive protein &gt; 0.75 mg/dl, neutrophil-to-lymphocyte ratio &gt; 1.5 and sick-appearance at 24 h. Use of these 3 variables together with blood culture status at 24 h, enabled identification of all infants that eventually developed sepsis through the decision tree model. Our decision tree has an area under the receiver operating characteristic curve of 0.94 (95% CI: 0.90–0.98).Conclusions: In non-sick appearing infants with a negative blood culture at 24 h and normal laboratory values, sepsis is highly unlikely and discontinuing antibiotics after 24 h is a viable option.

scholarly journals 1076. What Is the Positivity Delay of Blood Cultures in Infective Endocarditis?

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S322-S322
Author(s):  
Nahema Issa ◽  
Olivia Peuchant ◽  
Raphael Lecomte ◽  
Irene Machelart ◽  
Carine Greib ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Blood Culture ◽  
Median Time ◽  
Blood Cultures ◽  
Diagnostic Methods ◽  
University Hospital ◽  
Growth Time ◽  
Serological Tests ◽  
Time To Positivity ◽  
Maximum Delay

Abstract Background Blood culture is a key test for the positive diagnosis of infective endocarditis (IE). In order to detect certain so-called fastidious bacteria and to avoid the absence of documentation, it is customary to repeat the blood cultures (at least three series) and to keep them for 21 days. However, objective data regarding the positivity delay of blood cultures in case of infective endocarditis are lacking. Methods To determine the time to positivity of blood cultures during IE, all patients with documented IE by bacterial blood culture and presented to the Endocarditis team of our center were prospectively included. The study was conducted in a university hospital between 2013 and 2017. Results During the study, 441 patients with IE were hospitalized and 401 IE had a bacteriological documentation (91%), including 380 by blood cultures. In 21 cases, the bacteriological documentation was made by serological tests or specific PCR assays. Information on positivity delay was available for 237 patients (135 IE on native valve and 102 on prosthetic valve) and 183 of them (77%) had 4 aero-anaerobic series or more blood cultures. Of the 988 series sampled, 978 (99%) were positive. The main documented bacteria were staphylococci (41%), streptococci (32%), and enterococci (21%). The median time to positivity of the first blood culture was 11.4 hours [interquartile = 7.3 hours–16.7 hours] and the maximum delay was 93 hours. There was no difference in positivity delay between the 123 community acquired IE and the 114 healthcare-associated IE: 11.2 hours vs. 11.4 hours. The median growth time was 9.9 hours for S. aureus vs. 18 hours for coagulase negative staphylococci, 11 hours for enterococci and 10.4 hours for streptococci. In the case of IE complicated by extracardiac emboli, the median positivity delay was 9.7 hours in the case of S. aureus vs. 12.3 hours for the other bacteria. Conclusion In case of IE, our study shows that the median time positivity of the first blood culture is about 11 hours and no blood culture becomes positive beyond the fourth day. Slow-growing bacteria are identified by other diagnostic methods. We can, therefore, wonder about the need to multiply and conserve blood cultures beyond a week to document IE. Disclosures All authors: No reported disclosures.

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