Abstract
During an 8-month period at Children's Hospital, Oakland, Calif., a 9% rate for positive blood culture for children with Neisseria meningitidis meningitis was identified. The blood culture system used in each case was the BACTEC NR 730. This rate seemed significantly lower than previous rates (33 to 55%) (P.R. Dodge and M.N. Swartz, N. Engl. J. Med. 272:1003-1010, 1965; A.L. Hoyne and R.H. Brown, Ann. Intern. Med. 28:248-259, 1948; S. Levin and M.B. Painter, Ann. Intern. Med. 64:1049-1057, 1966). The low rate prompted our study. With 14 test strains, anaerobic and aerobic BACTEC bottles were evaluated for their ability to support and detect the growth of N. meningitidis. Sodium polyanetholesufonate (SPS) and inoculum size, two factors thought to affect the growth of N. meningitidis, were controlled for by use of bottles with and without SPS and by inoculum sizes simulating the magnitudes of bacteremia previously described for children infected with N. meningitidis (L.J. La Scolea, Jr., D. Dryja, T.D. Sullivan, L. Mosovich, N. Ellerstein, and E. Neter, J. Clin. Microbiol. 13:478-482, 1981). BACTEC failed to detect growth in aerobic bottles after 6 h of incubation, while 76 of 80 bottles (95%) showed growth when subcultured. At 24 h, BACTEC detected growth in only 29 of 80 bottles (36%); when subcultured, all 80 cultures grew confluently. At 48 h, BACTEC detected growth in the remaining 53 bottles. BACTEC failed to detect growth in anaerobic bottles at 6 h and at 1, 2, 4, and 5 days of incubation despite growth in subculture. Subcultures from bottles with tryptic soy broth with and without SPS showed growth in 63 to 76 bottles in 6 h and in all bottles after 24 h. The presence of SPS in BACTEC bottles had no effect on growth detection. On the basis of these studies and our clinical experience, we find the NR 730 system to be insensitive and unsuitable for detection of N.meningitidis in </= 24h. However, all test strains were detected after 48h.
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Selected References
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- Carey R. B. Clinical comparison of the Isolator 1.5 microbial tube and the BACTEC radiometric system for detection of bacteremia in children. J Clin Microbiol. 1984 May;19(5):634–638. doi: 10.1128/jcm.19.5.634-638.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DODGE P. R., SWARTZ M. N. BACTERIAL MENINGITIS--A REVIEW OF SELECTED ASPECTS. II. SPECIAL NEUROLOGIC PROBLEMS, POSTMENINGITIC COMPLICATIONS AND CLINICOPATHOLOGICAL CORRELATIONS. N Engl J Med. 1965 May 13;272:1003–CONCL. doi: 10.1056/NEJM196505132721906. [DOI] [PubMed] [Google Scholar]
- Jungkind D., Millan J., Allen S., Dyke J., Hill E. Clinical comparison of a new automated infrared blood culture system with the BACTEC 460 system. J Clin Microbiol. 1986 Feb;23(2):262–266. doi: 10.1128/jcm.23.2.262-266.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- La Scolea L. J., Jr, Dryja D., Sullivan T. D., Mosovich L., Ellerstein N., Neter E. Diagnosis of bacteremia in children by quantitative direct plating and a radiometric procedure. J Clin Microbiol. 1981 Mar;13(3):478–482. doi: 10.1128/jcm.13.3.478-482.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levin S., Painter M. B. The treatment of acute meningococcal infection in adults. A reappraisal. Ann Intern Med. 1966 May;64(5):1049–1056. doi: 10.7326/0003-4819-64-5-1049. [DOI] [PubMed] [Google Scholar]
- Meadow W. L., Schwartz I. K. Time course of radiometric detection of positive blood cultures in childhood. Pediatr Infect Dis. 1986 May-Jun;5(3):333–336. doi: 10.1097/00006454-198605000-00012. [DOI] [PubMed] [Google Scholar]
- Pai C. H., Sorger S. Enhancement of recovery of Neisseria meningitidis by gelatin in blood culture media. J Clin Microbiol. 1981 Jul;14(1):20–23. doi: 10.1128/jcm.14.1.20-23.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scribner R. K., Welch D. F. Neutralization of the inhibitory effect of sodium polyanetholesulfonate on Neisseria meningitidis in blood cultures processed with the Du Pont Isolator System. J Clin Microbiol. 1984 Jul;20(1):40–42. doi: 10.1128/jcm.20.1.40-42.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sullivan T. D., LaScolea L. J., Jr Neisseria meningitidis bacteremia in children: quantitation of bacteremia and spontaneous clinical recovery without antibiotic therapy. Pediatrics. 1987 Jul;80(1):63–67. [PubMed] [Google Scholar]
- Sullivan T. D., LaScolea L. J., Jr, Neter E. Relationship between the magnitude of bacteremia in children and the clinical disease. Pediatrics. 1982 Jun;69(6):699–702. [PubMed] [Google Scholar]