scholarly journals Detection of Carbapenemase-Producing Enterobacteriaceae in Positive Blood Culture Using an Immunochromatographic RESIST-4 O.K.N.V. Assay

2018 ◽  
Vol 62 (12) ◽  
Author(s):  
Aurélie Cointe ◽  
Stéphane Bonacorsi ◽  
Jeanne Truong ◽  
Claire Hobson ◽  
Catherine Doit ◽  
...  
Keyword(s):  
Blood Culture ◽  
Human Blood ◽  
Positive Blood Culture ◽  
Blood Cultures ◽  
Human Blood Cultures

ABSTRACT We evaluated the performance of the RESIST-4 O.K.N.V. assay (Coris) with 98 isolates to detect OXA-48-like and KPC-, NDM-, and VIM-type carbapenemases directly on positive human blood cultures. OXA-48-like and KPC-type isolates were correctly detected, but the detection of NDM- and VIM-type carbapenemases was weak and variable. We show that repeating the test on a 4-h subculture improves the detection of NDM- and VIM-type carbapenemases to 100%.

ATG Use Is Associated with Frequent Occurrence of Positive Blood Cultures in Patients in the Early Phase After Hematopoietic Stem Cell Transplantation

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4564-4564
Author(s):  
Marek Seweryn ◽  
Urszula Jarosz ◽  
Malgorzata Krawczyk-Kulis ◽  
Miroslaw Markiewicz ◽  
Grzegorz Helbig ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Blood Culture ◽  
Stem Cell Transplantation ◽  
Positive Blood Culture ◽  
Blood Cultures ◽  
Gram Negative Bacteria ◽  
Hematopoietic Stem ◽  
Gram Negative ◽  
Gram Positive Bacteria

Abstract Abstract 4564 Background: Infectious complications remain an important cause of morbidity and mortality in the early phase after hematopoietic stem cell transplantation (HSCT). Aim: The aim of this study was to assess the frequency of positive blood cultures and its potential correlation with different studied parameters in large patient population studied in the first 30 days after HSCT. Material and methods: 431 patients at median age of 47 years (range 18–85) transplanted between 2009–2011 for hematological and non-hematological malignancies were included in our analysis. There were 242 males and 189 females. Results: The indications for autologous and allogeneic HSCT were following: AML – 105 (24%), NHL – 86 (20%), MM – 75 (17,5%), HL – 48 (11%), ALL – 40 (9%), MDS – 17 (4%), AA – 15 (3,5%), CML – 12 (2,8%), PNH – 11 (2,6%), connective tissue diseases – 5 (1,2%), CLL – 3 (0,7%) and other – 14 (3,2%). The following transplant procedures were performed: ABCT – 213 (49%), ABMT – 3 (0,7%), alloBCT – 56 (13%), alloBMT – 21 (5%), URDBCT – 87 (20%), URDBMT – 51 (12%). Pre-transplant ATG and anti-CD52 antibody were used in 142 (33%) and 5 (1.2%) patients, respectively. Amongst 431 transplanted patients, 495 blood cultures were collected; range 0–8 (median 1). Eighty seven blood samples were positive (17,6%). The following pathogens were detected: gram-positive bacteria in 48% (n=42), gram-negative bacteria in 38% (n=33), fungi in 1% (n=1) and both G(+) and G(−) bacteria in 13%(n=11). The gram-positive bacteria included: Staphylococcus epidermidis: 21 (50%), Micrococcus spp: 4 (9%), Enterococcus faecium: 3 (7%), Enterococcus faecalis: 3 (7%), Streptococcus haemolyticus: 3 (7%). The following gram-negative bacteria were found: Enterobacter cloacae: 10 (30%), Escherichia coli: 7 (21%), Pseudomonas aeruginosa: 5 (15%), Klebsiella pneumonia: 5 (15%). Candida albicans was detected only in one case. The use of ATG was associated with higher number of total blood draw and positive blood cultures. No significant correlation was found between the specific pathogen and the use of ATG. Male gender was associated with significantly higher number of blood sampling and with tendency to higher number of positive blood cultures. The type of conditioning regimen, the source of stem cell and the donor origin (auto vs sibling vs unrelated) did not influence the number of positive blood culture. There was tendency to higher number of blood intake, but not positive blood culture in patients transplanted in NR if compared to PR or CR. Conclusions: Positive blood cultures were positive in about 20% of patients after HSCT. Only pre-transplant ATG use was associated with the higher number of positive blood culture. Disclosures: No relevant conflicts of interest to declare.

scholarly journals 81. Reducing Unnecessary Blood Cultures Through Diagnostic Stewardship

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S157-S157
Author(s):  
Sujeet Govindan ◽  
Luke Strnad
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Cost Savings ◽  
Bloodstream Infections ◽  
Central Line ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Candida Sp ◽  
Daily Frequency ◽  
Oregon Health

Abstract Background At our institution, we learned the frequency of blood cultures was sometimes being changed from “Once” to “Daily” without a defined number of days. We hypothesized this led to unnecessary blood cultures being performed. Methods Over a 3 month period from 12/6/2019-3/6/2020, we retrospectively evaluated the charts of patients who had a blood culture frequency changed to “Daily”. We evaluated if there was an initial positive blood culture within 48 hours of the “Daily” order being placed and the number of positive, negative, or “contaminant” sets of cultures drawn with the order. Contaminant blood cultures were defined as a contaminant species, present only once in the repeat cultures, and not present in initial positive cultures. Results 95 unique orders were placed with 406 sets of cultures drawn from 89 adults. ~20% of the time (17 orders) the order was placed without an initial positive blood culture. This led to 62 sets of cultures being drawn, only 1 of which came back positive. 78/95 orders had an initial positive blood culture. The most common initial organisms were Staphylococcus aureus (SA) (38), Candida sp (10), Enterobacterales sp (10), and coagulase negative staphylococci (7). 43/78 (55%) orders with an initial positive set had positive repeat cultures. SA (26) and Candida sp (8) were most common to have positive repeats. Central line associated bloodstream infections (CLABSI) were found in 5 of the orders and contaminant species were found in 4 of the orders. 54% of the patients who had a “Daily” order placed did not have positive repeat cultures. The majority of the cultures were drawn from Surgical (40 orders) and Medical (35 orders) services. Assuming that SA and Candida sp require 48 hours of negative blood cultures to document clearance and other species require 24 hours, it was estimated that 51% of the cultures drawn using the "Daily" frequency were unnecessary. Cost savings over a year of removing the "Daily" frequency would be ~&14,000. Data from "Daily" blood culture orders drawn at Oregon Health & Science University from 12/6/2019-3/6/2020 Conclusion Unnecessary blood cultures are drawn when the frequency of blood cultures is changed to "Daily". Repeat blood cultures had the greatest utility in bloodstream infections due to SA or Candida sp, and with CLABSI where the line is still in place. These results led to a stewardship intervention to change blood culture ordering at our institution. Disclosures All Authors: No reported disclosures

scholarly journals “A Four-Leaf Clover” Sign for Rapid Identification of Coagulase-Negative Staphylococci by Gram Staining From Positive Blood Culture: A Cross-Sectional Study

2020 ◽  
Author(s):  
Takahiro Matsuo ◽  
Kuniyoshi Hayashi ◽  
Aki Sakurai ◽  
Masumi Suzuki Shimizu ◽  
Masaya Morimoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Blood Culture ◽  
Positive Predictive Value ◽  
Positive Blood Culture ◽  
Predictive Value ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Gram Staining ◽  
Sensitivity Specificity

Abstract Background: Coagulase-negative staphylococci (CoNS) are one of the most common contaminant microorganisms isolated from blood cultures. Few studies exploring the use of Gram staining to distinguish between Staphylococcus aureus (SA) and CoNS have been reported. Here, this study aimed to explore whether morphological features of Gram staining could identify SA or CoNS.Methods: This study was conducted at St. Luke’s International Hospital from November 2016 to September 2017. The positive blood cultures for which the Gram staining showed gram-positive cocci (GPC) in clusters were included in our study. The direct smear of Gram staining obtained from positive blood culture bottles were examined within 24 hours of positivity. We have identified and characterized the following two signs: “four-leaf clover (FLC)” if 4 GPC gathered like a planar four-leaf clover and “grapes” if the GPC gathered like grapes in a three-dimensional form. The number of fields with FLC and grapes signs in 10 fields per slide with ×1,000 power was counted, and the results in a total of 20 fields with ×1,000 power were combined. We performed a logistic regression analysis to assess whether these signs could serve as factors distinguishing between SA and CoNS. The predictive ability of these signs was evaluated based on the sensitivity, specificity, positive predictive value, and negative predictive value for CoNS via receiver operating curve analysis.Results: In total, 106 blood cultures for which Gram staining showed GPC in clusters were examined; 46 (43%) were SA, and 60 (57%) were CoNS samples. The result of multivariate logistic regression analysis showed that the FLC sign was a statistically significant marker of CoNS with an odds ratio of 1.31 (95 % confidential interval (CI): 1.07–1.61, p<0.05). In aerobic bottles, sensitivity, specificity, positive predictive value, and negative predictive value for CoNS were 0.67, 0.91, 0.92, and 0.65, respectively, and the value of area under the curve was 0.79 (95% CI: 0.67–0.91).Conclusions: To our knowledge, this is the first study to show that the FLC could be a rapid and useful indicator to identify CoNS in aerobic bottles. Thus, the presence of FLC sings could help clinicians to suspect the possibility of CoNS before the final identification by cultures.

scholarly journals Impact of Direct From Blood Culture Identification of Pathogens Paired With Antimicrobial Stewardship Interventions in a Pediatric Hospital

2021 ◽  
Vol 26 (8) ◽  
pp. 802-808
Author(s):  
Lauren M. Puckett ◽  
Poonam Rajkotia ◽  
Lisa Coppola ◽  
Lori Baumgartner ◽  
Amity L. Roberts ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Pediatric Patients ◽  
Clinical Decision Making ◽  
Blood Cultures ◽  
Improvement Project ◽  
Maldi Tof ◽  
Culture Identification ◽  
Contaminated Blood ◽  
Organism Identification

OBJECTIVE Identification of organisms directly from positive blood culture by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has the potential for improved clinical outcomes through earlier organism identification and shorter time to appropriate clinical intervention. The uses of this technology in pediatric patients and its impact in this patient population have not been well described. METHODS Direct from positive blood culture organism identification via MALDI-TOF was implemented in September 2019. A quality improvement project was performed to assess its impact on admissions for contaminant blood cultures and time to effective and optimal antimicrobials and clinical decision-making. A pre- and post-implementation retrospective review for consecutive September through February time periods, was conducted on patients with positive monomicrobial blood cultures. Statistics were evaluated using Mann-Whitney U and χ2 tests. RESULTS One hundred nineteen patients with 131 unique blood cultures (65 in pre- and 66 in post-implementation) were identified. Time to identification was shorter, median 35.4 hours (IQR, 22.7–54.3) versus 42.3 hours (IQR, 36.5–49) in post- and pre-groups, respectively (p = 0.02). Patients were less likely to be admitted for a contaminated blood culture in the post-implementation, 26% versus 11% in the pre-implementation (p = 0.03) group. In patients treated for bacteremia, there was a shorter time to optimal therapy from Gram stain reporting in the post-implementation (median 42.7 hours [IQR, 27.2–72]) versus pre-implementation (median 60.8 hours [IQR, 42.9–80.6]) (p = 0.03). CONCLUSIONS Direct from positive blood culture identification by MALDI-TOF decreased time to effective and optimal antimicrobials and decreased unnecessary admission in pediatric patients for contaminated blood cultures.

scholarly journals Recent Emergence of Staphylococcus aureus Clonal Complex 398 in Human Blood Cultures

PLoS ONE ◽  
2012 ◽  
Vol 7 (10) ◽  
pp. e41855 ◽  
Author(s):  
Erwin Verkade ◽  
Anneke M. C. Bergmans ◽  
Andries E. Budding ◽  
Alex van Belkum ◽  
Paul Savelkoul ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Human Blood ◽  
Clonal Complex ◽  
Blood Cultures ◽  
Recent Emergence ◽  
Human Blood Cultures

scholarly journals Identification of Gram-negative bacilli directly from positive blood culture vials

2007 ◽  
Vol 56 (4) ◽  
pp. 475-479
Author(s):  
Siew Yong Ng ◽  
Lee Ling Kwang ◽  
Thean Yen Tan
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Clinical Management ◽  
Blood Cultures ◽  
Potential Saving ◽  
Biochemical Tests ◽  
Gram Negative ◽  
Genus Level ◽  
Direct Inoculation ◽  
Genus Identification

The provision of rapid results from positive blood cultures is important for the clinical management of septicaemia. This study tested the accuracy of direct inoculation of biochemical tests from positive blood culture vials for the identification of members of the Enterobacteriaceae and Acinetobacter species. A hundred and eighty-one samples were included in the study, with 25 % subsequently excluded as a result of mixed colonial growth. The study method successfully identified 133 (98 %) isolates from 136 vials to genus level and was technically simple to perform, requiring an additional 3 min for the processing of each positive vial. The results of this study demonstrate that a direct inoculation method provides acceptable genus identification of Gram-negative bacilli in positive blood culture vials, with a potential saving of 24 h compared with traditional methods.

Role of ascorbic acid on mercuric chloride-induced genotoxicity in human blood cultures

2001 ◽  
Vol 15 (6) ◽  
pp. 649-654 ◽  
Author(s):  
M.V Rao ◽  
N.J Chinoy ◽  
M.B Suthar ◽  
M.I Rajvanshi
Keyword(s):  
Ascorbic Acid ◽  
Human Blood ◽  
Mercuric Chloride ◽  
Blood Cultures ◽  
Human Blood Cultures
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