Abstract
The Plus Aerobic/F resin bottle of the BACTEC 9240 automated blood culture system (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md.) was compared with aerobic culture of the Isolator system (Wampole Laboratories, Cranbury, N.J.) for the detection of bloodstream microorganisms from 6,145 blood cultures collected from adult patients with suspected septicemia. The BACTEC resin bottles were incubated for 7 days, and the sediment from the Isolator tube was inoculated to sheep blood and chocolate agars which were incubated for 72 h and to inhibitory mold, brain heart infusion, and Sabouraud agars which were incubated for 21 days. A total of 622 microorganisms were recovered from 583 blood cultures. The BACTEC resin bottle recovered statistically significantly more pathogens overall than the Isolator system (P = 0.0006). When individual pathogens isolated from either system for a 7-day study period were assessed, it was determined that the BACTEC resin bottle detected statistically significantly more isolates of Staphylococcus aureus (P = 0.0113) and coagulase-negative Staphylococcus spp. (P = 0.0029) than the Isolator system. The BACTEC resin bottle also detected statistically significantly more bloodstream infections (septic episodes) caused by coagulase-negative Staphylococcus spp. (P = 0.0146). The Isolator system recovered statistically significantly more contaminants overall (P < 0.0001), and among this group of microorganisms, recovered statistically significantly more Bacillus spp. (P < 0.0001), coagulase-negative Staphylococcus spp. (P < 0.0001), and viridans group Streptococcus spp. (P = 0.0156). The Isolator system detected statistically significantly more isolates of Histoplasma capsulatum (P = 0.004), but all of these isolates were detected at > or = 7 days of incubation of fungal plates, i.e., after the system to system comparison study period (7 days). In blood culture sets which produced growth of the same pathogen in both systems, there was a statistically significant difference in median time to detection for all pathogens combined favoring the BACTEC resin bottle over the Isolator tube (P < 0.05). When assessing individual microorganisms, the median times for detection of S. aureus, Enterococcus spp., and Pseudomonas spp. were all statistically significantly less for the BACTEC system (P < 0.05). The BACTEC instrument had 79 (1.3%) false positive signals. The BACTEC system required less processing time than the Isolator system and eliminates the hands-on time for detection of positive cultures required with the Isolator system.
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Selected References
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- Bates D. W., Goldman L., Lee T. H. Contaminant blood cultures and resource utilization. The true consequences of false-positive results. JAMA. 1991 Jan 16;265(3):365–369. [PubMed] [Google Scholar]
- Cockerill F. R., 3rd, Torgerson C. A., Reed G. S., Vetter E. A., Weaver A. L., Dale J. C., Roberts G. D., Henry N. K., Ilstrup D. M., Rosenblatt J. E. Clinical comparison of difco ESP, Wampole isolator, and Becton Dickinson Septi-Chek aerobic blood culturing systems. J Clin Microbiol. 1996 Jan;34(1):20–24. doi: 10.1128/jcm.34.1.20-24.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Henry N. K., Grewell C. M., Van Grevenhof P. E., Ilstrup D. M., Washington J. A., 2nd Comparison of lysis-centrifugation with a biphasic blood culture medium for the recovery of aerobic and facultatively anaerobic bacteria. J Clin Microbiol. 1984 Sep;20(3):413–416. doi: 10.1128/jcm.20.3.413-416.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kellogg J. A., Bankert D. A., Manzella J. P., Parsey K. S., Scott S. L., Cavanaugh S. H. Clinical comparison of isolator and thiol broth with ESP aerobic and anaerobic bottles for recovery of pathogens from blood. J Clin Microbiol. 1994 Sep;32(9):2050–2055. doi: 10.1128/jcm.32.9.2050-2055.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kirkley B. A., Easley K. A., Washington J. A. Controlled clinical evaluation of Isolator and ESP aerobic blood culture systems for detection of bloodstream infections. J Clin Microbiol. 1994 Jun;32(6):1547–1549. doi: 10.1128/jcm.32.6.1547-1549.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nolte F. S., Williams J. M., Jerris R. C., Morello J. A., Leitch C. D., Matushek S., Schwabe L. D., Dorigan F., Kocka F. E. Multicenter clinical evaluation of a continuous monitoring blood culture system using fluorescent-sensor technology (BACTEC 9240). J Clin Microbiol. 1993 Mar;31(3):552–557. doi: 10.1128/jcm.31.3.552-557.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pohlman J. K., Kirkley B. A., Easley K. A., Washington J. A. Controlled clinical comparison of Isolator and BACTEC 9240 Aerobic/F resin bottle for detection of bloodstream infections. J Clin Microbiol. 1995 Oct;33(10):2525–2529. doi: 10.1128/jcm.33.10.2525-2529.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]