Abstract
AIM: To compare experience of positive blood cultures in successive years before and after changing from Signal (Unipath) to Bactec 9240 (Becton Dickinson) blood culture systems. METHODS: Analysis of data collected prospectively on 7967 Signal and 7062 Bactec blood culture sets. RESULTS: Significant growths occurred in 5.7% of Signal and 8.9% of Bactec cultures; 33.0% more significant isolates and 24.0% more episodes of bacteraemia were detected in the second year, following introduction of the Bactec system. Inpatient hospital activity increased by 8.2% between the first and second years, although the numbers of blood cultures received actually fell by 11.4%. There were striking increases in numbers of isolates of coagulase negative staphylococci (47.7%) and Enterobacteriaceae (56.8%) from Bactec cultures. Two anaerobic bacteraemias were detected in Signal blood cultures, whereas none was detected by the Bactec system, despite 12.1% of sets including an anaerobic bottle. Of significant positive cultures, 90.2% were detected within one day with the Bactec 9240, compared with only 50.0% of Signal cultures; 20.7% of significant positive Signal blood cultures were detected only on terminal subculture. Microorganisms that were not significant were isolated from 5.1% Signal and 3.8% Bactec cultures. CONCLUSIONS: Compared with the Signal system, the Bactec 9240 offers markedly more rapid and sensitive detection of bacteraemia, together with a lower rate of non-significant isolates. However, using a single PEDS PLUS/F bottle the few episodes of anaerobic bacteraemia that occur in children are likely to be missed.
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Selected References
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- Crepin O., Roussel-Delvallez M., Martin G. R., Courcol R. J. Effectiveness of resins in removing antibiotics from blood cultures. J Clin Microbiol. 1993 Mar;31(3):734–735. doi: 10.1128/jcm.31.3.734-735.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fox H., Healing D. E., George R. H. Evaluation of use of Signal system of blood culture in paediatrics. J Clin Pathol. 1988 Jun;41(6):683–686. doi: 10.1136/jcp.41.6.683. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gray J. W., Pedler S. J., Craft A. W., Kernahan J., Windebank K. P., Pearson A. D. Changing causes of septicaemia in paediatric oncology patients: effect of imipenem use. Eur J Pediatr. 1994 Feb;153(2):84–89. doi: 10.1007/BF01959213. [DOI] [PubMed] [Google Scholar]
- 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]
- Morello J. A., Matushek S. M., Dunne W. M., Hinds D. B. Performance of a BACTEC nonradiometric medium for pediatric blood cultures. J Clin Microbiol. 1991 Feb;29(2):359–362. doi: 10.1128/jcm.29.2.359-362.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Murdoch D. A., Koerner R. J., Speirs G. E., MacGowan A. P., Reeves D. S. Do blood cultures need continuous monitoring so that clinical action can be taken outside normal working hours? J Clin Pathol. 1995 Nov;48(11):1067–1068. doi: 10.1136/jcp.48.11.1067. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Neu H. C., Fracaro M., Bopp H., O'Keefe M., O'Connor J. Bacteraemia--a New York perception. J Antimicrob Chemother. 1990 Apr;25 (Suppl 100):107–113. doi: 10.1093/jac/25.suppl_c.107. [DOI] [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]
- Rimmer K., Cabot M. Comparison of Bactec NR-660 and Signal systems. J Clin Pathol. 1988 Jun;41(6):676–678. doi: 10.1136/jcp.41.6.676. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith J. A., Bryce E. A., Ngui-Yen J. H., Roberts F. J. Comparison of BACTEC 9240 and BacT/Alert blood culture systems in an adult hospital. J Clin Microbiol. 1995 Jul;33(7):1905–1908. doi: 10.1128/jcm.33.7.1905-1908.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vázquez F., Mendoza M. C., Villar M. H., Pérez F., Méndez F. J. Survey of bacteraemia in a Spanish hospital over a decade (1981-1990). J Hosp Infect. 1994 Feb;26(2):111–121. doi: 10.1016/0195-6701(94)90053-1. [DOI] [PubMed] [Google Scholar]
- Weinstein M. P., Murphy J. R., Reller L. B., Lichtenstein K. A. The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. II. Clinical observations, with special reference to factors influencing prognosis. Rev Infect Dis. 1983 Jan-Feb;5(1):54–70. doi: 10.1093/clinids/5.1.54. [DOI] [PubMed] [Google Scholar]
- Zaidi A. K., Knaut A. L., Mirrett S., Reller L. B. Value of routine anaerobic blood cultures for pediatric patients. J Pediatr. 1995 Aug;127(2):263–268. doi: 10.1016/s0022-3476(95)70305-5. [DOI] [PubMed] [Google Scholar]
- Zaidi A. K., Mirrett S., McDonald J. C., Rubin E. E., McDonald L. C., Weinstein M. P., Gupta M., Reller L. B. Controlled comparison of bioMérieux VITAL and BACTEC NR-660 systems for detection of bacteremia and fungemia in pediatric patients. J Clin Microbiol. 1997 Aug;35(8):2007–2012. doi: 10.1128/jcm.35.8.2007-2012.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
