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. 1994 Sep;32(9):2050–2055. doi: 10.1128/jcm.32.9.2050-2055.1994

Clinical comparison of isolator and thiol broth with ESP aerobic and anaerobic bottles for recovery of pathogens from blood.

J A Kellogg 1, D A Bankert 1, J P Manzella 1, K S Parsey 1, S L Scott 1, S H Cavanaugh 1
PMCID: PMC263940  PMID: 7814524

Abstract

The recovery of pathogens and the speed of their detection were determined for our conventional blood culture system (an Isolator [Wampole] and a 100-ml Thiol bottle [Difco]) compared with automated ESP aerobic and anaerobic bottles (80 ml each; Difco). Each of the four culture devices was inoculated with approximately 10 ml of blood from symptomatic patients weighing more than 80 lb (ca. 36 kg). From 7,070 sets of cultures for 2,841 patients, 607 clinically significant isolates were recovered: 456 (75.1%) from the Isolator, 353 (58.2%) from Thiol, 377 (62.1%) from ESP aerobic bottles, and 346 (57.0%) from ESP anaerobic bottles. Of the 607 isolates, 149 (24.5%) were detected only with the conventional system (Isolator and/or Thiol), and 65 (10.7%) were detected only with the ESP two-bottle system (P < 0.001). Our conventional system allowed for detection of significantly more isolates of members of the family Enterobacteriaceae (P < 0.001), Staphylococcus aureus (P < 0.01), Staphylococcus spp. (coagulase-negative) (P < 0.01), and Enterococcus spp. (P < 0.05), and ESP facilitated detection of significantly more isolates of S. pneumoniae (P < 0.01). When all four devices in a culture set were positive for the same isolate, no microbial species or group was detected significantly earlier ( > or = 24 h) by either blood culture system. The Isolator contamination rate (4.8%) was > or = 6 times the rate for any of the bottles. Of pathogens detected by the Isolator, 50% were recovered in counts of < or = 1.0 CFU/ml and 18% were recovered only as a single colony. The ESP system offered an automated, less labor-intensive blood culture system for which routine subcultures were not required, but the important considerations of culturing large volumes of blood and of obtaining at least two sets from each patient in our population were reemphasized.

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Selected References

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  1. Aronson M. D., Bor D. H. Blood cultures. Ann Intern Med. 1987 Feb;106(2):246–253. doi: 10.7326/0003-4819-106-2-246. [DOI] [PubMed] [Google Scholar]
  2. Auckenthaler R., Ilstrup D. M., Washington J. A., 2nd Comparison of recovery of organisms from blood cultures diluted 10% (volume/volume) and 20% (volume/volume). J Clin Microbiol. 1982 May;15(5):860–864. doi: 10.1128/jcm.15.5.860-864.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bates D. W., Lee T. H. Rapid classification of positive blood cultures. Prospective validation of a multivariate algorithm. JAMA. 1992 Apr 8;267(14):1962–1966. [PubMed] [Google Scholar]
  4. Bryan C. S. Clinical implications of positive blood cultures. Clin Microbiol Rev. 1989 Oct;2(4):329–353. doi: 10.1128/cmr.2.4.329. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dorsher C. W., Rosenblatt J. E., Wilson W. R., Ilstrup D. M. Anaerobic bacteremia: decreasing rate over a 15-year period. Rev Infect Dis. 1991 Jul-Aug;13(4):633–636. doi: 10.1093/clinids/13.4.633. [DOI] [PubMed] [Google Scholar]
  6. Ellner P. D., Kiehn T. E., Beebe J. L., McCarthy L. R. Critical analysis of hypertonic medium and agitation in detection of bacteremia. J Clin Microbiol. 1976 Sep;4(3):216–224. doi: 10.1128/jcm.4.3.216-224.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Geerdes H. F., Ziegler D., Lode H., Hund M., Loehr A., Fangmann W., Wagner J. Septicemia in 980 patients at a university hospital in Berlin: prospective studies during 4 selected years between 1979 and 1989. Clin Infect Dis. 1992 Dec;15(6):991–1002. doi: 10.1093/clind/15.6.991. [DOI] [PubMed] [Google Scholar]
  8. 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]
  9. Henry N. K., McLimans C. A., Wright A. J., Thompson R. L., Wilson W. R., Washington J. A., 2nd Microbiological and clinical evaluation of the isolator lysis-centrifugation blood culture tube. J Clin Microbiol. 1983 May;17(5):864–869. doi: 10.1128/jcm.17.5.864-869.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Ilstrup D. M., Washington J. A., 2nd The importance of volume of blood cultured in the detection of bacteremia and fungemia. Diagn Microbiol Infect Dis. 1983 Jun;1(2):107–110. doi: 10.1016/0732-8893(83)90039-1. [DOI] [PubMed] [Google Scholar]
  11. Kellogg J. A., Manzella J. P., McConville J. H. Clinical laboratory comparison of the 10-ml isolator blood culture system with BACTEC radiometric blood culture media. J Clin Microbiol. 1984 Oct;20(4):618–623. doi: 10.1128/jcm.20.4.618-623.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kieft H., Hoepelman A. I., Zhou W., Rozenberg-Arska M., Struyvenberg A., Verhoef J. The sepsis syndrome in a Dutch university hospital. Clinical observations. Arch Intern Med. 1993 Oct 11;153(19):2241–2247. [PubMed] [Google Scholar]
  13. Kiehn T. E., Wong B., Edwards F. F., Armstrong D. Comparative recovery of bacteria and yeasts from lysis-centrifugation and a conventional blood culture system. J Clin Microbiol. 1983 Aug;18(2):300–304. doi: 10.1128/jcm.18.2.300-304.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lombardi D. P., Engleberg N. C. Anaerobic bacteremia: incidence, patient characteristics, and clinical significance. Am J Med. 1992 Jan;92(1):53–60. doi: 10.1016/0002-9343(92)90015-4. [DOI] [PubMed] [Google Scholar]
  15. MacGregor R. R., Beaty H. N. Evaluation of positive blood cultures. Guidelines for early differentiation of contaminated from valid positive cultures. Arch Intern Med. 1972 Jul;130(1):84–87. [PubMed] [Google Scholar]
  16. Martin M. A., Pfaller M. A., Wenzel R. P. Coagulase-negative staphylococcal bacteremia. Mortality and hospital stay. Ann Intern Med. 1989 Jan 1;110(1):9–16. doi: 10.7326/0003-4819-110-1-9. [DOI] [PubMed] [Google Scholar]
  17. Mermel L. A., Maki D. G. Detection of bacteremia in adults: consequences of culturing an inadequate volume of blood. Ann Intern Med. 1993 Aug 15;119(4):270–272. doi: 10.7326/0003-4819-119-4-199308150-00003. [DOI] [PubMed] [Google Scholar]
  18. Morris A. J., Wilson M. L., Mirrett S., Reller L. B. Rationale for selective use of anaerobic blood cultures. J Clin Microbiol. 1993 Aug;31(8):2110–2113. doi: 10.1128/jcm.31.8.2110-2113.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Murray P. R., Traynor P., Hopson D. Critical assessment of blood culture techniques: analysis of recovery of obligate and facultative anaerobes, strict aerobic bacteria, and fungi in aerobic and anaerobic blood culture bottles. J Clin Microbiol. 1992 Jun;30(6):1462–1468. doi: 10.1128/jcm.30.6.1462-1468.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Pittet D., Li N., Wenzel R. P. Association of secondary and polymicrobial nosocomial bloodstream infections with higher mortality. Eur J Clin Microbiol Infect Dis. 1993 Nov;12(11):813–819. doi: 10.1007/BF02000400. [DOI] [PubMed] [Google Scholar]
  21. Plorde J. J., Tenover F. C., Carlson L. G. Specimen volume versus yield in the BACTEC blood culture system. J Clin Microbiol. 1985 Aug;22(2):292–295. doi: 10.1128/jcm.22.2.292-295.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Ponce de Leon S., Wenzel R. P. Hospital-acquired bloodstream infections with Staphylococcus epidermidis. Review of 100 cases. Am J Med. 1984 Oct;77(4):639–644. doi: 10.1016/0002-9343(84)90354-1. [DOI] [PubMed] [Google Scholar]
  23. Salventi J. F., Davies T. A., Randall E. L., Whitaker S., Waters J. R. Effect of blood dilution on recovery of organisms from clinical blood cultures in medium containing sodium polyanethol sulfonate. J Clin Microbiol. 1979 Feb;9(2):248–252. doi: 10.1128/jcm.9.2.248-252.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Sharp S. E., McLaughlin J. C., Goodman J. M., Moore J., Spanos S. M., Keller D. W., 3rd, Poppiti R. J., Jr Clinical assessment of anaerobic isolates from blood cultures. Diagn Microbiol Infect Dis. 1993 Jul;17(1):19–22. doi: 10.1016/0732-8893(93)90064-e. [DOI] [PubMed] [Google Scholar]
  25. Tenney J. H., Reller L. B., Mirrett S., Wang W. L., Weinstein M. P. Controlled evaluation of the volume of blood cultured in detection of bacteremia and fungemia. J Clin Microbiol. 1982 Apr;15(4):558–561. doi: 10.1128/jcm.15.4.558-561.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Washington J. A., 2nd, Ilstrup D. M. Blood cultures: issues and controversies. Rev Infect Dis. 1986 Sep-Oct;8(5):792–802. doi: 10.1093/clinids/8.5.792. [DOI] [PubMed] [Google Scholar]
  27. Weinstein M. P., Reller L. B., Murphy J. R. Clinical importance of polymicrobial bacteremia. Diagn Microbiol Infect Dis. 1986 Sep;5(3):185–196. doi: 10.1016/0732-8893(86)90001-5. [DOI] [PubMed] [Google Scholar]
  28. Weinstein M. P., Reller L. B., Murphy J. R., Lichtenstein K. A. The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. I. Laboratory and epidemiologic observations. Rev Infect Dis. 1983 Jan-Feb;5(1):35–53. doi: 10.1093/clinids/5.1.35. [DOI] [PubMed] [Google Scholar]
  29. Winchester P. D., Todd J. K., Roe M. H. Bacteremia in hospitalized children. Am J Dis Child. 1977 Jul;131(7):753–758. doi: 10.1001/archpedi.1977.02120200035009. [DOI] [PubMed] [Google Scholar]
  30. Yagupsky P., Nolte F. S. Quantitative aspects of septicemia. Clin Microbiol Rev. 1990 Jul;3(3):269–279. doi: 10.1128/cmr.3.3.269. [DOI] [PMC free article] [PubMed] [Google Scholar]

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