Evaluation of the Nanosphere Verigene Gram-Positive Blood Culture Assay with the VersaTREK Blood Culture System and Assessment of Possible Impact on Selected Patients

INTRODUCTION: Sepsis is the leading cause of death in Intensive ICU patients worldwide.Blood cultures are the ‘gold standard’ for identifying pathogens causing septicemia and in directing appropriate antibiotic therapy. The present study was aimed to compare sensitivity of automated BACTEC 9120 blood culture system and conventional blood culture method in identifying true pathogenic organism, to compare the time needed for the detection of microorganisms by conventional method of blood culture and by automated BACTEC 9120 blood culture system and to evaluate the susceptibility pattern of antibiotics for pathogens isolated. MATERIAL AND METHODS: Study was done over a period of one year from April 2015 to March 2016. A total of 636 blood samples were collected andsubjected to blood culture by BACTEC 9120 and conventional method. The statistical tests applied were Sensitivity, Specificity, Positive predictive value, Negative predictive value, T-test and kappa statistics. RESULTS: Out of 636 blood samples clinically significant isolates were recovered from 85 samples by BACTEC, of which 74 were bacterial pathogens and 11 were candida. In conventional method out of 80 significant isolates 69 were bacterial and 11 were candida. Gram positive (majority Staphylococci) were more commonly isolated than Gram negative (majority Acinetobacter and E.coli). Mean time to detect was 19.47 hours and 3.02 days, by BACTEC 9120 and conventional method respectively. Vancomycin, Teicoplanin and Linezolid were found to be the most effective (100%) for gram positive bacteria and for gram negative bacteria Colistin (70-100%), Polymyxin-B (70-100%) were the most effective. CONCLUSION: Sepsis is associated with prolonged hospital stay, increased costs and with a high mortality. The use of BACTEC BD blood culture system is better for rapid identification of blood borne pathogens followed by determining actual antimicrobial treatment in the scenario of multi drug resistance so as to improve patient’s outcome.

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Use of the BacT/Alert Blood Culture System for Culture of Sterile Body Fluids Other than Blood

Journal of Clinical Microbiology ◽

10.1128/jcm.36.11.3273-3277.1998 ◽

1998 ◽

Vol 36 (11) ◽

pp. 3273-3277 ◽

Cited By ~ 40

Author(s):

Paul Bourbeau ◽

Julie Riley ◽

Barbara J. Heiter ◽

Ron Master ◽

Carol Young ◽

...

Keyword(s):

Blood Culture ◽

Culture System ◽

Body Fluids ◽

Coagulase Negative Staphylococci ◽

Culture Methods ◽

Gram Positive ◽

Blood Culture System ◽

Anaerobic Bottle ◽

Gram Positive Cocci ◽

Sterile Body Fluids

Studies have demonstrated that large-volume culture methods for sterile body fluids other than blood increase recovery compared to traditional plated-medium methods. BacT/Alert is a fully automated blood culture system for detecting bacteremia and fungemia. In this study, we compared culture in BacT/Alert standard aerobic and anaerobic bottles, BacT/Alert FAN aerobic and FAN anaerobic bottles, and culture on routine media for six specimen types, i.e., continuous ambulatory peritoneal dialysate (CAPD), peritoneal, amniotic, pericardial, synovial, and pleural fluids. Specimen volumes were divided equally among the three arms of the study. A total of 1,157 specimens were tested, with 227 significant isolates recovered from 193 specimens. Recovery by method was as follows: standard bottles, 186 of 227 (82%); FAN bottles, 217 of 227 (96%); and routine culture, 184 of 227 (81%). The FAN bottles recovered significantly more gram-positive cocci (P < 0.001), Staphylococcus aureus(P = 0.003), coagulase-negative staphylococci (P = 0.008), gram-negative bacilli (P< 0.001), Enterobacteriaceae (P = 0.005), and total organisms (P < 0.001) than the routine culture. There were no significant differences in recovery between the standard bottles and the routine culture. The FAN aerobic bottle recovered significantly more gram-positive cocci (P < 0.001), S. aureus isolates (P < 0.001), coagulase-negative staphyococci (P = 0.003), and total organisms (P< 0.001) than the standard aerobic bottle, while the FAN anaerobic bottle recovered significantly more gram-positive cocci (P < 0.001), S. aureus isolates (P < 0.001), Enterobacteriaceae(P = 0.03), and total organisms (P < 0.001) than the standard anaerobic bottle. For specific specimen types, significantly more isolates were recovered from the FAN bottles compared to the routine culture for synovial (P < 0.001) and CAPD (P = 0.004) fluids. Overall, the FAN bottles were superior in performance to both the standard bottles and the routine culture for detection of microorganisms from the types of sterile body fluids included in this study.

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