scholarly journals Controlled Clinical Comparison of bioMérieux VITAL and BACTEC NR-660 Blood Culture Systems for Detection of Bacteremia and Fungemia in Adults

1999 ◽  
Vol 37 (6) ◽  
pp. 1709-1713 ◽  
Author(s):  
Michael L. Wilson ◽  
Stanley Mirrett ◽  
L. Clifford McDonald ◽  
Melvin P. Weinstein ◽  
Jose Fune ◽  
...  

A total of 9,446 blood cultures were collected from adult patients at three university-affiliated hospitals. Of these, 8,943 cultures were received with both aerobic bottles filled adequately; 885 yielded 1,016 microorganisms, including 622 isolates (61%) that were the cause of sepsis, 337 isolates (33%) that were contaminants, and 57 isolates (6%) that were indeterminate as the cause of sepsis. With the exception of Staphylococcus aureus, which was recovered more often from VITAL aerobic bottles, more pathogenic microorganisms were recovered from BACTEC NR6 (aerobic) bottles than from VITAL aerobic bottles. Growth of pathogenic microorganisms was detected earlier in VITAL aerobic bottles. A total of 8,647 blood cultures were received with both anaerobic bottles filled adequately; 655 yielded 740 microorganisms, including 486 isolates (66%) that were the cause of sepsis, 215 isolates (29%) that were contaminants, and 39 isolates (6%) that were indeterminate as the cause of sepsis. More pathogenic microorganisms were recovered from VITAL anaerobic bottles than from BACTEC NR7 (anaerobic) bottles. Growth of pathogenic microorganisms was detected earlier in VITAL anaerobic bottles. In 8,500 sets all four bottles were received adequately filled. When paired aerobic and anaerobic bottle sets (systems) were compared, more pathogenic microorganisms (again with the exception of S. aureus) were recovered from the BACTEC system. For the 304 septic episodes (253 unimicrobial and 51 polymicrobial), significantly more were detected by the BACTEC system. We conclude that VITAL requires modification to improve recovery of pathogenic microorganisms to make it competitive with other commercially available blood culture systems.

2021 ◽  
Vol 3 (4) ◽  
Author(s):  
Donald Brody Duncan ◽  
Yasmeen Marbaniang Vincent ◽  
Cheryl Main

Introduction. Patients with Staphylococcus aureus bacteriuria (SABU) often have underlying invasive disease, including S. aureus bacteremia (SAB). It has been proposed that most patients with SABU should have a blood culture done to rule out SAB. A preliminary audit suggested that our local hospitals had a low rate of follow-up blood culture orders for patients with SABU. In response to this, our microbiology laboratory changed the comment appended to urine cultures with growth of S. aureus to make a more assertive link between SABU and SAB and to recommend follow-up blood cultures. Aim. We designed a retrospective quasi-experimental study to see if the change in microbiology comment wording had an effect on clinician behaviour. We hypothesized that this simple comment change to make a more assertive link between SABU and SAB would lead to an increase in follow-up blood culture orders. Methodology. We used microbiology records to identify adult patients with urine cultures positive for Staphylococcus aureus at three acute-care hospitals in Hamilton, Ontario, Canada, for 1 year pre- and post-intervention. We recorded urine and blood culture results, timing, patient demographics, and in-hospital mortality. Results. A total of 243 adult patients with urine cultures with S. aureus were identified for inclusion. The primary outcome was met, as there was a significant increase in blood culture orders between the pre-intervention and post-intervention groups (66.9 % vs 80.4 %). This difference was mainly driven by an increase for emergency department and urgent care patients (30.6 % vs 63.6 %). The inpatient group had a high baseline rate of blood culture orders that did not change significantly (80.0 % vs 84.7 %). There was no significant change in detection of SAB (23.5 % vs 32.7 %) or inpatient mortality (18.0 % vs 24.7 %). Conclusion. Our study shows that a simple, purposeful comment appended to urine cultures with S. aureus leads to a significant increase in follow-up blood culture orders.


PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Sara A. Schutzman ◽  
Stephen Petrycki ◽  
Gary R. Fleisher

To investigate the occurrence and outcome of bacteremia associated with otitis media, charts were reviewed from patients who were 3 to 36 months of age, had temperatures ≥39°C, and were diagnosed with isolated clinical otitis media. A total of 2982 patients were identified. Blood cultures were obtained from 1666 (56%). Of the 1666 patients, who had blood drawn for cultures, 50 (3.0%) had bacteremia. These included 39 with Streptococcus pneumoniae, 4 with Haemophilus influenzae, 2 with Neisseria meningitidis, 3 with Salmonella species, and 2 with Staphylococcus aureus. The incidence of bacteremia increased at higher temperatures, being 1.9% at temperatures ≤40°C and 5.0% at temperatures >40°C. Younger children were more likely to have bacteremia; 3.7% ≤12 months of age, 2.4% 13 to 24 months of age, and 1.9% 25 to 36 months of age had blood culture results that were positive (not significant). Reevaluation of the 50 bacteremic patients showed that 9 patients had continued fever, 3 patients had persistent bacteremia, pneumonia developed in 1 patient, and meningitis developed in 1 patient. It was concluded that (1) 3% of young febrile children with otitis media have bacteremia at the time of evaluation, a rate comparable to that previously reported in children with no focus of infection; (2) the incidence of bacteremia increases at higher temperatures; and (3) most febrile children with otitis media do well. The clinician must therefore weigh the potential benefit of drawing a blood culture to identify children at risk for complications against the inherent cost, inconvenience, and discomfort.


2000 ◽  
Vol 38 (10) ◽  
pp. 3864-3866 ◽  
Author(s):  
James W. Snyder ◽  
Karen S. Benzing ◽  
Gina K. Munier ◽  
Grace D. Bostic ◽  
Pamela S. Bozigar ◽  
...  

The current BacT/Alert standard aerobic (VA) blood culture bottle was redesigned and designated a nonvented aerobic (NVA) culture bottle; this bottle does not require venting. A total of 3,873 sets of blood samples for culture were obtained from adult patients with suspected bacteremia or fungemia. The NVA bottle showed performance equivalent to that of the VA bottle for recovery and speed of detection of microorganisms from blood without the need for venting the bottle.


2020 ◽  
Vol 58 (9) ◽  
Author(s):  
Jennifer Dien Bard ◽  
Todd P. Chang ◽  
Rebecca Yee ◽  
Keya Manshadi ◽  
Nhan Lichtenfeld ◽  
...  

ABSTRACT Anaerobes are an important but uncommon cause of bloodstream infections (BSIs). For pediatric patients, routine inclusion of an anaerobic blood culture alongside the aerobic remains controversial. We implemented automatic anaerobic blood culture alongside aerobic blood cultures in a pediatric emergency department (ED) and sought to determine changes in recovery of obligate and facultative anaerobes. This was a cohort study in a pediatric ED (August 2015 to July 2018) that began in February 2017. Blood culture positivity results for true pathogens and contaminants were assessed, along with a secondary outcome of time to positivity (TTP) of blood culture. A total of 14,180 blood cultures (5,202 preimplementation and 8,978 postimplementation) were collected, with 8.8% (456) and 7.1% (635) positive cultures in the pre- and postimplementation phases, respectively. Of 635 positive cultures in the postimplementation phase, aerobic blood cultures recovered 7.6% (349/4,615), whereas anaerobic blood cultures recovered 6.6% (286/4,363). In 211/421 (50.0%) paired blood cultures, an organism was recovered in both cultures. The number of cases where organisms were only recovered from an aerobic or an anaerobic bottle in the paired cultures were 126 (30.0%) and 84 (20.0%), respectively. The TTP was comparable regardless of bottle type. Recovery of true pathogens from blood cultures was approximately 7 h faster than recovery of contaminants. Although inclusion of anaerobic blood cultures only recovered 2 (0.69%) obligate anaerobes, it did allow for recovery of clinically significant pathogens that were negative in aerobic blood cultures and supports the routine collection of both bottles in pediatric patients with a concern of bloodstream infections.


2017 ◽  
Vol 9 (04) ◽  
pp. 314-316 ◽  
Author(s):  
Felipe S. Lupinacci ◽  
Daniel Bussius ◽  
Felipe Acquesta ◽  
Gustavo Fam ◽  
Raphael Rossi ◽  
...  

Abstract BACKGROUND: Clindamycin has become an important antimicrobial option for the treatment of Staphylococcus aureus. However, little is known about the current patterns of clindamycin-susceptibility in S. aureus invasive isolates, both in our country and in other developing countries in the world. AIMS: The aim of this study was to determine the prevalence of constitutive and inducible clindamycin resistance in methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) blood culture isolates in São Paulo, Brazil. MATERIALS AND METHODS: From July 2011 to June 2012, all S. aureus isolates from blood cultures collected at our hospital were included in the study. Antimicrobial susceptibility testing was performed according to recommendations of the Clinical and Laboratory Standards Institute. RESULTS: Total prevalence of clindamycin resistance was 68%, including 7.2% with inducible resistance. In MRSA resistance rate was 90.8% whereas in MSSA the rate was 32.7%. CONCLUSIONS: Our high prevalence of clindamycin resistance highlights the importance of performing D-test in a routine base, as well of maintaining continued surveillance for the prevalence of clindamycin resistance.


1984 ◽  
Vol 5 (3) ◽  
pp. 142-143 ◽  
Author(s):  
D.J. Flournoy

Coagulase-negative staphylococci (CONS) have only recently gained notoriety as pathogens. Several reports have established their pathogenicity in bacterial endocarditis, prosthetic heart valve endocarditis, intraventricular shunts for treatment of hydrocephalus and intravenous catheters. One difficult decision for physicians is determining whether a particular CONS isolate is pathogenic or contaminant. The differentiation of pathogenic and contaminant CONS has recently been noted, but further studies are needed to aid in this differentiation. Data on antimicrobial susceptibilities of positive blood culture isolates were recently compiled at this institution. This report compares antimicrobial susceptibilities of pathogenic and contaminant CONS and Staphylococcus aureus blood culture isolates from 1961-1981 at this institution.


2002 ◽  
Vol 44 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Egidio Francesco Viganò ◽  
Emanuela Vasconi ◽  
Carlo Agrappi ◽  
Pierangelo Clerici

2021 ◽  
Vol 8 (4) ◽  
pp. 327-332
Author(s):  
Humera Qudsia Fatima Ansari ◽  
Lubna Saher ◽  
Mustafa Afzal

: 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.


2003 ◽  
Vol 9 (1-2) ◽  
pp. 185-190
Author(s):  
N. M. Kaplan

Blood cultures submitted to the Clinical Microbiology Laboratory, Queen Alia Military Hospital, Amman during 1999-2001 were examined to evaluate thermonuclease testing for identifying Staphylococcus aureus in blood culture broths growing gram-positive cocci. Of 170 cultures studied, 129 yielded gram-positive staphylococci and 41 yielded other gram-positive cocci. Toluidine blue-deoxynucleic acid agar plates were used to test for thermonuclease activity. St and ard tube coagulase tests were performed on the isolates. Direct detection of thermonuclease activity in 76 blood culture broths containing gram-positive staphylococci showed 100% correlation with subsequent tube coagulase tests. The thermonuclease test provides a fast, specific and reliable confirmation of S. aureus bacteraemia by direct examination of blood culture broths that contain gram-positive cocci. This allows for timely, optimal antibiotic therapy


1979 ◽  
Vol 9 (3) ◽  
pp. 347-350
Author(s):  
D Fay ◽  
J E Oldfather

Insufficient data are available to establish the reliability of direct disk diffusion susceptibility tests performed utilizing positive blood culture broth as inoculum. When Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa ATCC 27853 were used, 0.03 ml of turbid overnight blood culture broth was found to produce zone diameters closely approximating the size of diameters obtained by a standardized method. Results of direct (0.03 ml of inoculum) and standardized susceptibility tests were then compared for 116 positive blood cultures (1,069 individual disk comparisons). There were 1,011 test agreements (94.6%). There were also 48 (4.5%) minor discrepancies (change between sensitive and intermediate or between intermediate and resistant) and 10 (0.9%) major discrepancies (change between sensitive and resistant). The major discrepancies were randomly distributed among several organisms and antibiotics. Discrepancies occurred most frequently in the more clinically acceptable direction; i.e., in 79.3% the direct test indicted greater resistance than the standardized test. These data establish that 0.03 ml of turbid overnight blood culture broth produces results which compare closely to those obtained with standard methods, and in practice yield direct susceptibility results with a clinically acceptable level of reliability.


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