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Cox CR, Weghorn KN, Ruger K, Powers-Fletcher MV, Powell EA, Mortensen JE. Clinical utility of multiplex PCR in the detection of pathogens from sterile body fluids. J Clin Microbiol 2024; 62:e0161123. [PMID: 38470149 PMCID: PMC11005351 DOI: 10.1128/jcm.01611-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/21/2024] [Indexed: 03/13/2024] Open
Abstract
Rapid identification of pathogens in normally sterile body fluid (NSBF) is essential for appropriate patient management, specifically antimicrobial therapy. Limited sensitivity and increased time to detection of traditional culture prompted us to evaluate additional testing to contribute to the diagnosis of infection. The purpose of this study was to evaluate the GenMark Dx ePlex Blood Culture Identification (BCID) Panels on positive body fluids inoculated into blood culture bottles for the detection of microorganisms. A total of 88 positive body fluids from blood culture bottles were analyzed using a Gram-Positive, Gram-Negative, and/or Fungal pathogen BCID Panel based on the Gram stain result. Each result was compared to routine culture performed from the positive bottle. When using culture as a reference standard, we found the ePlex multiplex panel performed with a positive percent agreement of 96.5% and a negative percent agreement of 99.8%. The use of multiplex PCR may be a useful supplement to routine culture for NSBF in blood culture bottles. IMPORTANCE The identification of pathogens in normally sterile body fluid (NSBF) is performed using routine culture, the current gold standard. Limitations of this method include sensitivity and increased turnaround times which could potentially delay vital patient care, especially antimicrobial therapy. Adaptations of NSBF in blood culture bottles prompted us to consider the utility of additional methods to bridge the gap in diagnostic challenges for these life-threatening infections. Multiplex molecular panels have been manufactured for use with multiple specimen types including blood, cerebral spinal fluid, stool, and respiratory. Therefore, the purpose of this study was to evaluate the off-label use of ePlex Blood Culture Identification Panels on positive body fluids grown in blood culture bottles for the detection of microorganisms for research purposes.
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Affiliation(s)
- Christina R. Cox
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kristin N. Weghorn
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Katie Ruger
- Department of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Margaret V. Powers-Fletcher
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Eleanor A. Powell
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Joel E. Mortensen
- Department of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
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2
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Alabdullatif MI. Hemovigilance data: An effective approach for evaluating bacterial protection systems for platelet transfusions. Asian J Transfus Sci 2024; 18:91-96. [PMID: 39036690 PMCID: PMC11259335 DOI: 10.4103/ajts.ajts_157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 05/23/2021] [Accepted: 05/29/2022] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Septic transfusion reactions due to bacterial contamination in platelet concentrates (PCs) are continually reported to hemovigilance (HV) programs. Worldwide, blood centers use different systems to avoid transfusion-associated bacterial sepsis in PCs. Herein, national HV data were gathered to compare bacterial protection systems and to assess the risk of bacterial contamination. MATERIALS AND METHODS HV data with definite transfusion-associated bacterial sepsis in PCs were obtained from Australia, Canada, the United Kingdom (U. K.), and Switzerland between 2006 and 2016. These data were reviewed to evaluate bacterial protection systems including early small-volume (ESV), early large-volume (ELV), and delayed large-volume (DLV) bacterial culture screening and pathogen inactivation (PI) treatment. RESULTS Implementation of DLV bacterial culture screening in the U. K. and PI treatment in Switzerland resulted in significant reductions (P < 0.05) in transfusion-associated bacterial sepsis for the period of 2011-2016 compared to the prior 4 years (2006-2010). Approximately 1.86 million DLV bacterial culture-screened PCs and 0.21 million PI-treated PCs were issued with no reported septic fatalities nor cases of life-threatening sepsis. In Australia, two life-threatening septic transfusion reactions (1.923 per million) were reported out of almost 1.04 million ELV bacterial culture-screened PCs, and no septic fatalities were reported. Meanwhile, in Canada, four life-threatening septic transfusion reactions (3.6/million) and one fatality (0.9/million) were observed in about 1.11 million ESV bacterial culture-screened PCs. CONCLUSION DLV bacterial culture and PI treatment significantly reduced the incidence of septic reactions. The advantages and disadvantages of both systems merit further investigation before implementation.
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Affiliation(s)
- Meshari I. Alabdullatif
- Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Pathology, SmartLab, Riyadh, Saudi Arabia
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3
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Tomazin R, Pliberšek T, Oštrbenk Valenčak A, Matos T. Different BD BACTEC ™ Blood Culture Bottle Types for the Detection of Fungi in Simulated Sterile Body Fluid Samples. Diagnostics (Basel) 2023; 13:diagnostics13101699. [PMID: 37238183 DOI: 10.3390/diagnostics13101699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Blood culture systems are a potential alternative to classical cultivation of fungi on mycological media, but there are limited data on the suitability of these systems for culturing other sample types (e.g., sterile body fluids). We conducted a prospective study to evaluate different types of blood culture (BC) bottles for the detection of different fungal species in non-blood samples. A total of 43 fungal isolates were tested for their ability to grow in BD BACTEC Mycosis-IC/F (Mycosis bottles), BD BACTEC Plus Aerobic/F (Aerobic bottles) and BD BACTEC Plus Anaerobic/F (Anaerobic bottles) (Becton Dickinson, East Rutherford, NJ, USA) BC bottles inoculated with spiked samples without the addition of blood or fastidious organism supplement. Time to detection (TTD) was determined for all BC types tested and compared between groups. In general, Mycosis and Aerobic bottles were similar (p > 0.05). The Anaerobic bottles failed to support growth in >86% of cases. The Mycosis bottles were superior in detecting Candida glabrata, Cryptococcus spp. and Aspergillus spp. (p < 0.05). The performance of Mycosis and Aerobic bottles was similar, but if cryptococcosis or aspergillosis is suspected, the use of Mycosis bottles is recommended. Anaerobic bottles are not recommended for fungal detection.
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Affiliation(s)
- Rok Tomazin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
| | | | - Anja Oštrbenk Valenčak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
| | - Tadeja Matos
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
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4
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Bansal N, Sachdeva N, Bhurani D, Agarwal N, Halder R, Goyal P. Candida Empyema in Febrile Neutropenia - Augmented value of direct inoculation into BacT/Alert blood culture vials. Indian J Med Microbiol 2022; 40:440-442. [PMID: 35654714 DOI: 10.1016/j.ijmmb.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 11/05/2022]
Abstract
Candida empyema is an uncommon complication of febrile neutropenia. We present 4 such cases which highlight the importance of direct inoculation of body fluids in automated blood culture bottle leading to increased yield. Our cases and review of literature also highlight that echinocandins have poor penetration into pleural fluid; azoles (especially voriconazole) should be preferred as drug of choice.
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Affiliation(s)
- Nitin Bansal
- Infectious Diseases, Rajiv Gandhi Cancer Institute, New Delhi, India.
| | - Neelam Sachdeva
- Microbiology, Rajiv Gandhi Cancer Institute, New Delhi, India.
| | - Dinesh Bhurani
- Hematology, Rajiv Gandhi Cancer Institute, New Delhi, India
| | | | - Rohan Halder
- Hematology, Rajiv Gandhi Cancer Institute, New Delhi, India
| | - Pankaj Goyal
- Medical Oncology, Rajiv Gandhi Cancer Institute, New Delhi, India
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5
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Tan SJ, Gardam DJ, Radinger A, Le T, Nure M, Boan P. Fungal yield from sterile specimens. Med Mycol 2021; 60:6412528. [PMID: 34718695 DOI: 10.1093/mmy/myab066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/19/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Clinicians may not request fungal culture when it is indicated. For sterile specimens without a specific request for fungal culture, in addition to bacteriology media, we routinely incubated a Sabouraud dextrose agar (SAB) plate for 4 weeks. From 44635 sterile specimens from years 2011 to 2016, 2722 (6.1%) had fungal request. Fungi were identified from 1037 (2.3%) specimens, 292 (0.6%) from specimens with specific fungal request, 574 (1.3%) from bacteriology media, and 171 (0.4%) solely from SAB plate (of 171, 77 were deemed clinically significant and 55 were treated). Relying on request for fungal studies from sterile specimens underdiagnosed fungal infection. Routine fungal culture had a modest incremental yield at a moderately high cost. LAY SUMMARY Routine fungal culture of sterile specimens had a modest incremental yield to routine bacteriology culture and specific fungal request at a moderately high financial cost.
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Affiliation(s)
- Shu Jin Tan
- Department of Microbiology, Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Perth, Australia
| | - Dianne J Gardam
- Department of Microbiology, Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Perth, Australia
| | - Arron Radinger
- Department of Microbiology, Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Perth, Australia
| | - Tam Le
- Department of Microbiology, Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Perth, Australia
| | - Mariyam Nure
- Department of Microbiology, Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Perth, Australia
| | - Peter Boan
- Department of Microbiology, Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Perth, Australia.,Department of Infectious Diseases, Fiona Stanley Fremantle Hospital Group, Perth, Australia
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Liu-Walsh F, Tierney NK, Hauschild J, Rush AK, Masucci J, Leo GC, Capone KA. Prebiotic Colloidal Oat Supports the Growth of Cutaneous Commensal Bacteria Including S. epidermidis and Enhances the Production of Lactic Acid. Clin Cosmet Investig Dermatol 2021; 14:73-82. [PMID: 33500646 PMCID: PMC7826061 DOI: 10.2147/ccid.s253386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/15/2020] [Indexed: 01/05/2023]
Abstract
Background Multiple skin conditions have been associated with alterations in the diversity and composition of the skin microbiome, including dry skin and atopic dermatitis. In these conditions, a number of commensal skin bacteria have been implicated in supporting a healthy skin barrier, including Staphylococcus epidermidis. Recent clinical studies in patients with mild-to-moderate atopic dermatitis and dry/itchy skin have shown significantly improved skin barrier function and microbial diversity upon treatment with moisturizers containing 1% colloidal oat. We hypothesized that direct use of colloidal oat by skin microbes contributes to these therapeutic benefits. Methods Skin bacterial growth was assessed using the BacT/ALERT system. Staphylococcus aureus and S. epidermidis growth rates and metabolism were compared in an in vitro competition assay. The effect of a 1% colloidal oat-containing moisturizer on lactic acid content of the stratum corneum was clinically assessed in subjects with moderate-to-severe dry skin. S. epidermidis gene expression was evaluated by next-generation mRNA sequencing. Short-chain fatty acids were quantified in bacterial culture supernatants. Results In vitro, colloidal oat increased the growth rate of S. epidermidis vs S. aureus, as well as the metabolism of S. epidermidis. Colloidal oat also significantly increased lactic acid concentrations in supernatants of both strains and decreased pH, consistent with clinical findings that 6-week use of a 1% colloidal oat-containing lotion significantly increased lactic acid on dry skin. Further analyses suggest that colloidal oat alters the gene expression profile of S. epidermidis. Conclusion Colloidal oat directly affects the growth, metabolism, lactic acid production, and gene expression of skin commensal bacteria, as shown via in vitro studies. The increased production of lactic acid reflects clinical observations with colloidal oat-containing skin moisturizers. Our findings suggest a new mechanism for colloidal oat as a skin prebiotic, which may contribute to improvements in skin and microbiome diversity in various skin conditions, including dry/itchy skin and atopic dermatitis.
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Affiliation(s)
| | | | - James Hauschild
- Johnson & Johnson Microbiological Quality & Sterility Assurance, Johnson & Johnson Inc., Raritan, NJ, USA
| | | | - John Masucci
- Janssen R&D Companies of Johnson & Johnson, Springhouse, PA, USA
| | - Gregory C Leo
- Janssen R&D Companies of Johnson & Johnson, Springhouse, PA, USA
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Yoo IY, Kang OK, Lee MK, Kim YJ, Cho SY, Huh K, Kang CI, Chung DR, Peck KR, Huh HJ, Lee NY. Comparison of 16S Ribosomal RNA Targeted Sequencing and Culture for Bacterial Identification in Normally Sterile Body Fluid Samples: Report of a 10-Year Clinical Laboratory Review. Ann Lab Med 2020; 40:63-67. [PMID: 31432641 PMCID: PMC6713660 DOI: 10.3343/alm.2020.40.1.63] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/02/2019] [Accepted: 08/07/2019] [Indexed: 11/19/2022] Open
Abstract
As 16S ribosomal RNA (rRNA)-targeted sequencing can detect DNA from non-viable bacteria, it can be used to identify pathogens from clinical samples even in patients pretreated with antibiotics. We compared the results of 16S rRNA-targeted sequencing and culture for identifying bacterial species in normally sterile body fluid (NSBF): cerebrospinal, pericardial, peritoneal and pleural fluids. Over a 10-year period, a total of 312 NSBF samples were evaluated simultaneously using 16S rRNA-targeted sequencing and culture. Results were concordant in 287/312 (92.0%) samples, including 277 (88.8%) negative and 10 (3.2%) positive samples. Of the 16 sequencing-positive, culture-negative samples, eight showed clinically relevant isolates that included Fusobacterium nucleatum subsp. nucleatum, Streptococcus pneumoniae, and Staphylococcus spp. All these samples were obtained from the patients pretreated with antibiotics. The diagnostic yield of 16S rRNA-targeted sequencing combined with culture was 11.2%, while that of culture alone was 6.1%. 16S rRNA-targeted sequencing in conjunction with culture could be useful for identifying bacteria in NSBF samples, especially when patients have been pretreated with antibiotics and when anaerobic infection is suspected.
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Affiliation(s)
- In Young Yoo
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - On Kyun Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myoung Keun Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yae Jean Kim
- Division of Infectious Diseases, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Center for Infection Prevention and Control, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol In Kang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Center for Infection Prevention and Control, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Nam Yong Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Günther SK, Geiss C, Kaiser SJ, Mutters NT, Günther F. Microbiological Control of Cellular Products: The Relevance of the Cellular Matrix, Incubation Temperature, and Atmosphere for the Detection Performance of Automated Culture Systems. Transfus Med Hemother 2019; 47:254-263. [PMID: 32595430 DOI: 10.1159/000503397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 09/16/2019] [Indexed: 11/19/2022] Open
Abstract
Background The microbiological control of cellular products sometimes causes significant procedural issues for quality control laboratories. According to the European Pharmacopoeia (EP), the microbiological control of cellular products requires a 7- to 14-day incubation period at two different incubation temperatures using aerobic and anaerobic growth media. However, the suitability of these test conditions for efficient quality control can be influenced by many conditions, such as the expected microbial spectrum of contamination or the texture and composition of the cellular product. Because of interference, direct inoculation and membrane filtration as reference methods of pharmacopoeia are largely unsuitable for the microbiological control of cellular products; therefore, alternative and, above all, automated methods are the focus of interest. Objective The aim of our study was to evaluate the method suitability and possible effects of cell matrix, incubation temperature, and oxygen pressure on the detection performance of automated culture systems. Methods The BacT/ALERT® 3D<sup>TM</sup> Dual T system (bioMérieux, Nürtingen, Germany) was used to evaluate the factors influencing automated microbiological control of cellular products. The tests were performed using microbial strains recommended by the EP for microbiological method suitability testing and additional relevant possible contaminants of human-derived stem-cell products under varying culture and cell matrix conditions. Results All contaminants were detected by the system in the required period of 2-5 days. Low incubation temperatures (22°C) had overall negative effects on the detection kinetics of each type of microbial contamination. The adverse effects of the accompanying cell matrix on the detection properties of the system could be compensated in our study by incubation at 32°C in both the aerobic and the anaerobic culture conditions. Conclusion Automated culture techniques represent a sufficient approach for the microbiological control of cellular products. The negative effects of the cell matrix and microbial contamination on the detection performance can be compensated by the application of variable culture conditions in the automated culture system.
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Affiliation(s)
- Susanne-Katharina Günther
- German Red Cross Blood Donor Service, Mannheim, Germany.,Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University of Marburg, Marburg, Germany
| | - Celina Geiss
- Medical Microbiology and Hygiene, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan J Kaiser
- Medical Microbiology and Hygiene, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Nico T Mutters
- Medical Microbiology and Hygiene, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.,Department of Infection Control, Freiburg University Hospital, Freiburg, Germany
| | - Frank Günther
- Medical Microbiology and Hygiene, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.,Division of Infection Control, Medical Microbiology and Hygiene, Philipps University of Marburg, Marburg, Germany
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9
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Synovial fluid culture: agar plates vs. blood culture bottles for microbiological identification. Clin Rheumatol 2019; 39:275-279. [PMID: 31489513 DOI: 10.1007/s10067-019-04740-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Bacteriological diagnosis of septic arthritis (SA) is complicated. Agar plates are the main culture method and yields 40-60% of positive bacterial detection. Addition of bottled culture broth (Bactec®) as a method for detecting synovial microorganisms is common. The advantages of this method and the combination of both have not been thoroughly investigated. This study evaluates an added value of the Bactec culture broth as a single method or as combined with the agar-plate culture. METHODS All culture aspirates of SA-suspected patients were analyzed. All cases with a positive result by either method were reviewed for background data and clinical diagnosis. RESULTS Out of 5000 synovial fluid samples, a clinical diagnosis of SA was suspected in 1024 cases. Samples processed by both culture methods were extracted during the same event. Bactec® vials were positive for significant bacterial detection in 113/148 cases (76.4%) while agar-plate cultures were positive in only 96/154 (62.3%) representing higher sensitivity of 0.5 vs. 0.42 and a positive predictive value (PPV) of 0.76 vs. 0.62. Bacterial detection by both methods combined was positive in 137/221 (62%) and did not achieve a significant increment. CONCLUSIONS The Bactec® method has many advantages in bacteriological identification of synovial infection, including a broader identification spectrum, faster response time, and superior qualities of identification although being more expensive. This method has a better yield in detecting septic arthritis and might be considered a single method for synovial fluid culture in cases suspected for SA.Key Points• The Bactec method had improved detection rates.• Culturing by agar plates and Bactec revealed higher sensitivity and lower specificity.• The use of the blood culture bottles (Bactec system) alone will raise the detection rate of septic arthritis with lower false positive rates and at lower costs.
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10
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Sanabria A, Røkeberg MEO, Johannessen M, Sollid JE, Simonsen GS, Hanssen AM. Culturing periprosthetic tissue in BacT/Alert® Virtuo blood culture system leads to improved and faster detection of prosthetic joint infections. BMC Infect Dis 2019; 19:607. [PMID: 31291897 PMCID: PMC6621959 DOI: 10.1186/s12879-019-4206-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/19/2019] [Indexed: 12/21/2022] Open
Abstract
Background Blood culture bottles (BCBs) provide a semiautomated method for culturing periprosthetic tissue specimens. A study evaluating BCBs for culturing clinical samples other than body fluids is needed before implementation into clinical practice. Our objective was to evaluate use of the BacT/Alert® Virtuo blood culture system for culturing periprosthetic tissue specimens. Methods The study was performed through the analysis of spiked (n = 36) and clinical (n = 158) periprosthetic tissue samples. Clinical samples were analyzed by the BCB method and the results were compared to the conventional microbiological culture-based method for time to detection and microorganisms identified. Results The BacT/Alert® Virtuo blood culture system detected relevant bacteria for prosthetic joint infection in both spiked and clinical samples. The BCB method was found to be as sensitive (79%) as the conventional method (76%) (p = 0.844) during the analyses of clinical samples. The BCB method yielded positive results much faster than the conventional method: 89% against 27% detection within 24 h, respectively. The median detection time was 11.1 h for the BCB method (12 h and 11 h for the aerobic and the anaerobic BCBs, correspondingly). Conclusion We recommend using the BacT/Alert® Virtuo blood culture system for analyzing prosthetic joint tissue, since this detect efficiently and more rapidly a wider range of bacteria than the conventional microbiological method. Electronic supplementary material The online version of this article (10.1186/s12879-019-4206-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adriana Sanabria
- Research Group for Host-Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
| | - Merethe E O Røkeberg
- Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Mona Johannessen
- Research Group for Host-Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Johanna Ericson Sollid
- Research Group for Host-Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Gunnar Skov Simonsen
- Research Group for Host-Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.,Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Anne-Merethe Hanssen
- Research Group for Host-Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
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Bacterial Isolates and Drug Susceptibility Pattern of Sterile Body Fluids from Tertiary Hospital, Northern Ethiopia: A Four-Year Retrospective Study. J Pathog 2019; 2019:5456067. [PMID: 31263599 PMCID: PMC6556257 DOI: 10.1155/2019/5456067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/13/2019] [Indexed: 12/26/2022] Open
Abstract
This study was conducted in Ayder comprehensive specialized Hospital, Mekelle, Northern Ethiopia, to determine the bacterial profiles and drug susceptibility pattern from body fluids. A total of 218 patients were investigated, of which 146 (67%) were males. The age of the study subjects ranged from 2 days to 80 years with 96(44%) in the age group of 15 years and above. The overall bacterial infection was 44 (20.2 %) of which gram positive bacteria were prevalent, 23 (52.3%) than gram negative bacteria 21 (47.7%). The predominantly isolated bacteria were S. pneumonia, followed by K.pneumoniae, S. aureus, and E coli. Multidrug resistance was observed in 12 (100%) of the isolated gram positive bacteria and in 6 (75%) of the isolated gram negative bacteria.
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12
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Chen NN, Wu PL, Chen HC, Huang TY, Lai LJ. Prevalence of microbial contamination in donor corneas. Taiwan J Ophthalmol 2019; 9:179-184. [PMID: 31572655 PMCID: PMC6759555 DOI: 10.4103/tjo.tjo_60_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/29/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/PURPOSE: Postoperative infection is the most disastrous complication of penetrating keratoplasty (PK). Corneoscleral rim culture provided information regarding subsequent infections. Our aims were to identify the incidence of microbial contamination in donor corneas and to report the recovery of bacteria with two culture methods, i.e., conventional culture media after aerobic/anaerobic cotton swabs and blood culture media (Fastidious Antibiotic Neutralization [FAN]). MATERIALS AND METHODS: A total of 118 patients underwent PK. Corneoscleral rim cultures were performed using aerobic/anaerobic culture cotton swabs (Transystem™, COPAN, Italia) with subsequent convention media and blood culture media (FAN bottle, BD BACTEC™, USA). The results of the different methods were reported and analyzed. RESULTS: Microorganisms were recovered from 24 in total 118 cases (20.3%, n = 118), 14 from blood culture media (FAN) (11.8%, n = 118), 9 from conventional culture media after aerobic/anaerobic cotton swabs (7.63%, n = 118), and 2 from fungus culture (1.69%, n = 118). The most commonly identified pathogen was coagulase-negative Staphylococcus (CoNS) (n = 13, 54.2%), and more isolates of CoNS and staphylococcus aureus were recovered from blood culture media (FAN) than those from conventional culture media after aerobic/anaerobic cotton swabs (13 vs. 4, P = 0.05). Conversely, more nonfermentative Gram-negative bacilli were recovered from conventional culture media after aerobic/anaerobic cotton swabs. None of the 24 cases with positive corneoscleral rim cultures reported ocular infection for the recipients in at least 6 months’ follow-up. CONCLUSION: The conventional culture media after aerobic/anaerobic cotton swabs and blood culture media (FAN) did not yield identical isolates of bacteria. The blood culture media (FAN) could further yield Gram-positive bacteria in addition to those recovered from convention media. It seemed adding gentamicin and streptomycin could achieve bacteriostatic effect instead of the bactericidal effect. The administration of postoperative antibiotic in the recipient was suggested.
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Affiliation(s)
- Nan-Ni Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Pei-Lun Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hung-Chi Chen
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Tsung-Yu Huang
- Department of Infection, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Li-Ju Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Miller JM, Binnicker MJ, Campbell S, Carroll KC, Chapin KC, Gilligan PH, Gonzalez MD, Jerris RC, Kehl SC, Patel R, Pritt BS, Richter SS, Robinson-Dunn B, Schwartzman JD, Snyder JW, Telford S, Theel ES, Thomson RB, Weinstein MP, Yao JD. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis 2018; 67:e1-e94. [PMID: 29955859 PMCID: PMC7108105 DOI: 10.1093/cid/ciy381] [Citation(s) in RCA: 288] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 04/28/2018] [Indexed: 12/12/2022] Open
Abstract
The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. This document presents a system-based approach rather than specimen-based approach, and includes bloodstream and cardiovascular system infections, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper and lower respiratory infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, genital infections, and other skin and soft tissue infections; or into etiologic agent groups, including arthropod-borne infections, viral syndromes, and blood and tissue parasite infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. In addition, the pediatric needs of specimen management are also emphasized. There is intentional redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a guidance for physicians in choosing tests that will aid them to quickly and accurately diagnose infectious diseases in their patients.
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Affiliation(s)
| | - Matthew J Binnicker
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | - Karen C Carroll
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | | | - Peter H Gilligan
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill
| | - Mark D Gonzalez
- Department of Pathology, Children’s Healthcare of Atlanta, Georgia
| | - Robert C Jerris
- Department of Pathology, Children’s Healthcare of Atlanta, Georgia
| | | | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Bobbi S Pritt
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | - Barbara Robinson-Dunn
- Department of Pathology and Laboratory Medicine, Beaumont Health, Royal Oak, Michigan
| | | | - James W Snyder
- Department of Pathology and Laboratory Medicine, University of Louisville, Kentucky
| | - Sam Telford
- Department of Infectious Disease and Global Health, Tufts University, North Grafton, Massachusetts
| | - Elitza S Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Richard B Thomson
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois
| | - Melvin P Weinstein
- Departments of Medicine and Pathology & Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Joseph D Yao
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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14
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She RC, Romney MG, Jang W, Walker T, Karichu JK, Richter SS. Performance of the BacT/Alert Virtuo Microbial Detection System for the culture of sterile body fluids: prospective multicentre study. Clin Microbiol Infect 2017; 24:992-996. [PMID: 29274462 DOI: 10.1016/j.cmi.2017.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Continuous monitoring blood culture systems are commonly used for sterile body fluid cultures. In this multicentre study, we evaluated the performance of the new-generation BacT/Alert Virtuo system compared to the BacT/Alert 3D and conventional culture for the recovery of microorganisms from sterile body fluids. METHODS Peritoneal, cerebrospinal, pericardial, pleural and synovial fluids from adult patients submitted for culture were collected from three different centres. Specimens were inoculated into two bottles of the same bottle type (SA, SN, FA Plus or FN Plus) in equal volumes for simultaneous incubation in the Virtuo and 3D instruments. Each specimen was also Gram stained and seeded to solid media. RESULTS A total of 811 specimens were inoculated to 1257 bottle pairs. The Virtuo and 3D showed equivalent recovery of clinically significant microorganisms (127/155, 81.9%, vs. 126/155, 81.3%, respectively). Solid media cultures recovered fewer pathogens than either continuous monitoring system (95/155, 61.3%, p <0.001), including significantly fewer Enterobacteriaceae and enterococci. The Virtuo was significantly faster than the 3D in median time to detection of isolates from the same specimen (12.5 (range, 2.8-101.5) hours vs. 15.5 (range, 4.3-78.5) hours, p <0.001). Direct specimen Gram stain detected the eventual pathogen in 30 (26.1%) of 115 significant positive specimens. CONCLUSIONS The BacT/Alert Virtuo system was equivalent to the 3D system in organism recovery from sterile body fluid culture but showed faster detection of growth as a result of design enhancements.
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Affiliation(s)
- R C She
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
| | - M G Romney
- St Paul's Hospital, Providence Health Care, University of British Columbia, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Jang
- St Paul's Hospital, Providence Health Care, University of British Columbia, Vancouver, British Columbia, Canada
| | - T Walker
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - J K Karichu
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - S S Richter
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
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15
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Bugno A, Saes DPS, Almodovar AAB, Dua K, Awasthi R, Ghisleni DDM, Hirota MT, de Oliveira WA, de Jesus Andreoli Pinto T. Performance Survey and Comparison Between Rapid Sterility Testing Method and Pharmacopoeia Sterility Test. J Pharm Innov 2017; 13:27-35. [PMID: 29497461 PMCID: PMC5816116 DOI: 10.1007/s12247-017-9303-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The sterility test described in pharmacopoeial compendia requires a 14-day incubation period to obtain a valid analytical result. Therefore, the use of alternative methods to evaluate the sterility of pharmaceuticals, such as the BacT/Alert® 3D system, is particularly interesting, because it allows a reduced incubation period and lower associated costs. Considering that the BacT/Alert® 3D system offers several culture media formulations developed for this microbial detection system, the present study was aimed to evaluate and compare the performance of BacT/Alert® 3D with the pharmacopoeial sterility test. There was no significant difference between the ability of the culture media to allow detection of microbial contamination. However, the rapid sterility testing method allowed a more rapid detection of the challenge microorganisms, which indicates that the system is a viable alternative for assessing the sterility of injectable products.
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Affiliation(s)
- Adriana Bugno
- Adolfo Lutz Institute, 355 Dr. Arnaldo Avenue, São Paulo, 01246-000 Brazil
| | | | | | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007 Australia
- School of Pharmacy and Biomedical Sciences, The University of Newcastle, Newcastle, Callaghan, NSW 2308 Australia
- School of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh 173229 India
| | - Rajendra Awasthi
- NKBR College of Pharmacy & Research Centre, Meerut, Uttar Pradesh 245206 India
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16
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Comparison of BacT/Alert FAN and FAN Plus Bottles with Conventional Medium for Culturing Cerebrospinal Fluid. J Clin Microbiol 2016; 54:2837-2840. [PMID: 27629894 DOI: 10.1128/jcm.01147-16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/30/2016] [Indexed: 11/20/2022] Open
Abstract
We compared the BacT/Alert system FAN and FAN Plus media to conventional media for culturing cerebrospinal fluid (CSF) with 2,545 samples. FAN/FAN Plus bottles showed better performance for isolating microorganisms in CSF than conventional media (positive rate, 7.2% [182/2,545] versus 3.1% [80/2,545]). The incremental recovery rate of Cryptococcus neoformans from FAN Plus bottles was higher than that from FAN bottles.
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17
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Abstract
ABSTRACT
The immunocompromised host is a particularly vulnerable population in whom routine and unusual infections can easily and frequently occur. Prosthetic devices are commonly used in these patients and the infections associated with those devices present a number of challenges for both the microbiologist and the clinician. Biofilms play a major role in device-related infections, which may contribute to failed attempts to recover organisms from routine culture methods. Moreover, device-related microorganisms can be difficult to eradicate by antibiotic therapy alone. Changes in clinical practice and advances in laboratory diagnostics have provided significant improvements in the detection and accurate diagnosis of device-related infections. Disruption of the bacterial biofilm plays an essential role in recovering the causative agent in culture. Various culture and nucleic acid amplification techniques are more accurate to guide directed treatment regimens. This chapter reviews the performance characteristics of currently available diagnostic assays and summarizes published guidelines, where available, for addressing suspected infected prosthetic devices.
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18
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Heo EY, Shin S, Chung HS, Jeong YJ, Oh SH, Kim DK. The effect of using blood culture bottle of bronchoalveolar larvage fluid in pneumonia. BMC Infect Dis 2016; 16:247. [PMID: 27266871 PMCID: PMC4895882 DOI: 10.1186/s12879-016-1591-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 05/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pneumonia is a primary cause of morbidity and mortality in infectious disease, and increasing antimicrobial resistance has raised concerns of treatment failure. Therefore, we evaluated the value of a blood culture bottle for bronchoalveolar lavage (BAL) samples on pathogen identification and on treatment modification in patients with pneumonia. METHODS We conducted a prospective study and enrolled 39 patients who were hospitalized for pneumonia. Enrolled patients underwent BAL; a 10-ml aliquot was transferred to a sterile container for standard quantitative culture, and a 5 ml aliquot was transferred to both an aerobic and an anaerobic blood culture bottle. RESULTS Microbes were detected in all 39 (100 %) specimens and possible pathogens were identified in 34 patients (84.6 %) from BAL blood culture bottles. In contrast, microbes were detected in 10 patients (25.6 %) and possible pathogens were isolated in 8 patients (20.5 %) in BAL fluid using conventional culture methods. Finally, 8 of 39 (20.5 %) patients changed antibiotics according to the BAL blood culture results and pneumonia improved in 6 of these patients. CONCLUSIONS Using blood culture bottles for BAL sampling in patients with pneumonia is a sensitive method to detect pathogens in order to identify an adequate antibiotic treatment regimen.
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Affiliation(s)
- Eun Young Heo
- Department of Internal Medicine, SNU-SMG Boramae Medical Center, 41, Boramaegil, Dong-jak gu, Seoul, Korea.
| | - Sue Shin
- Department of Laboratory Medicine, SNU-SMG Boramae Medical Center, Seoul, Korea
| | - Hee Soon Chung
- Department of Internal Medicine, SNU-SMG Boramae Medical Center, 41, Boramaegil, Dong-jak gu, Seoul, Korea
| | - Yun-Jeong Jeong
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - So Hee Oh
- Department of Medical Statistics, SNU-SMG Boramae Medical Center, Seoul, Korea
| | - Deog Kyeom Kim
- Department of Internal Medicine, SNU-SMG Boramae Medical Center, 41, Boramaegil, Dong-jak gu, Seoul, Korea
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19
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Cawcutt KA, Bhatti MM, Nelson DR. Pleural fluid infection caused by Dietzia cinnamea. Diagn Microbiol Infect Dis 2016; 85:496-7. [PMID: 27312689 DOI: 10.1016/j.diagmicrobio.2016.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 04/07/2016] [Indexed: 10/21/2022]
Abstract
Dietzia cinnamea was recovered from pleural fluid in an immunocompromised patient by inoculating blood culture bottles and was identified with matrix-assisted laser desorption ionization-time-of-flight mass spectrometry. The case shows the expanding ability of microbiology laboratories to identify rare organisms through newer techniques and technology.
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Affiliation(s)
- Kelly A Cawcutt
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Micah M Bhatti
- Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA
| | - Darlene R Nelson
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
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20
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Bugno A, Lira RS, Oliveira WA, Almodovar AAB, Saes DPS, Pinto TDJA. Application of the BacT/ALERTR 3D system for sterility testing of injectable products. Braz J Microbiol 2015; 46:743-7. [PMID: 26413055 PMCID: PMC4568852 DOI: 10.1590/s1517-838246320140587] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/19/2014] [Indexed: 11/21/2022] Open
Abstract
Sterility testing as described in the pharmacopoeia compendia requires a 14-day
incubation period to obtain an analytical result. Alternative methods that could be
applied to evaluating product sterility are especially interesting due to the
possibility of reducing this incubation period and thus the associated costs. The
aims of this study were to evaluate the performance of the BacT/ALERTR 3D
system in detecting microorganisms in large-volume parenteral solutions that were
intentionally contaminated and to compare this system to pharmacopoeia sterility
testing using the membrane filtration method. The results indicated that there were
no significant differences between the methods regarding the ability to detect
microbial contamination; however, detection with the BacT/ALERTR 3D system
was faster compared to the pharmacopoeia method. Therefore, the
BacT/ALERTR 3D system is a viable alternative for assessing the
sterility of injectable products.
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Affiliation(s)
- Adriana Bugno
- Centro de Medicamentos, Cosméticos e Saneantes, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | - Rodolfo Santos Lira
- Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP, Brazil
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21
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Kim J, Cho SI, Kim YK, Park YJ. Evaluation of the Usefulness of MacConkey Agar and Colistin-Nalidixic Acid Blood Agar for Body Fluids, Peritoneal Fluid, and Wound/Abscess Specimens. ANNALS OF CLINICAL MICROBIOLOGY 2015. [DOI: 10.5145/acm.2015.18.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jayoung Kim
- Department of Laboratory Medicine, International St. Mary's Hospital, The Catholic Kwandong University of Korea, Incheon, Korea
| | - Sung-il Cho
- Department of Laboratory Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
| | | | - Yeon-Joon Park
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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22
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Rapid identification of microorganisms from sterile body fluids by use of FilmArray. J Clin Microbiol 2014; 53:710-2. [PMID: 25520440 DOI: 10.1128/jcm.03434-14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
We evaluated the clinical performance of the FilmArray blood culture identification (BCID) panel in the identification of microorganisms from positive blood culture bottles inoculated with sterile body fluids. All organisms included in the FA BCID panel were accurately identified in 84/84 (100%) and 18/24 (75%) samples with mono- and polymicrobial growth, respectively.
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23
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Baron EJ, Miller JM, Weinstein MP, Richter SS, Gilligan PH, Thomson RB, Bourbeau P, Carroll KC, Kehl SC, Dunne WM, Robinson-Dunn B, Schwartzman JD, Chapin KC, Snyder JW, Forbes BA, Patel R, Rosenblatt JE, Pritt BS. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2013 recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)(a). Clin Infect Dis 2013; 57:e22-e121. [PMID: 23845951 PMCID: PMC3719886 DOI: 10.1093/cid/cit278] [Citation(s) in RCA: 313] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 04/22/2013] [Indexed: 12/18/2022] Open
Abstract
The critical role of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician and the microbiologists who provide enormous value to the health care team. This document, developed by both laboratory and clinical experts, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. Sections are divided into anatomic systems, including Bloodstream Infections and Infections of the Cardiovascular System, Central Nervous System Infections, Ocular Infections, Soft Tissue Infections of the Head and Neck, Upper Respiratory Infections, Lower Respiratory Tract infections, Infections of the Gastrointestinal Tract, Intraabdominal Infections, Bone and Joint Infections, Urinary Tract Infections, Genital Infections, and Skin and Soft Tissue Infections; or into etiologic agent groups, including Tickborne Infections, Viral Syndromes, and Blood and Tissue Parasite Infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. There is redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a reference to guide physicians in choosing tests that will aid them to diagnose infectious diseases in their patients.
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Affiliation(s)
- Ellen Jo Baron
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
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24
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The performance of 4 different supplements and 5 blood culture bottles types in detection of bacteria and Candida spp. in simulated sterile body fluid cultures. Diagn Microbiol Infect Dis 2013; 77:1-4. [PMID: 23867327 DOI: 10.1016/j.diagmicrobio.2013.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/27/2013] [Accepted: 05/28/2013] [Indexed: 11/20/2022]
Abstract
The purpose of this investigation was to evaluate the performance of 4 supplements: horse blood, fastidious organisms supplement (FOS), haemin isovitalex albumine (HIA), and brain heart infusion-haemin isovitalex albumine (BHI-HIA) and 5 blood culture bottles: Bactec Mycosis IC/F, Plus Aerobic/F, Peds Plus/F from the Bactec 9240 system, and BacT/Alert FA and BacT/Alert PF from the BacT/Alert 3D system, in detection of bacteria and Candida spp. in simulated sterile body fluids other than blood models. In total, 8 reference strains (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Candida albicans, and Candida parapsilosis) and 11 clinical bacteria and yeast isolates (6 isolates from cerebrospinal fluid and 5 isolates from blood) were included in this study. Horse blood, FOS, and HIA were significantly better than no supplements (P < 0.0001, P < 0.0002, and P = 0.05, respectively) in detection of bacteria. Interestingly, there was no significant difference between BHI-HIA and bottles without any supplements. Sixty bottles analyzed of which 59 (98.33%) bottles with horse blood, 53 (88.33%) with FOS, 45 (75.00%) with HIA, and 43 (71.67%) with BHI-HIA signaled positive. The positivity rates with horse blood were significantly higher than with HIA and BHI-HIA (P < 0.0005 and P < 0.0001, respectively). Similarly, the blood culture bottles with horse blood had shorter time to detection (TTD) compared to bottles with FOS and HIA (P < 0.05 and P < 0.0001, respectively). When yeasts were analyzed, almost all (124/125) blood culture bottles with Candida spp. signaled positive even in the absence of supplements. Bactec Mycosis IC/F had significantly shorter TTD compared to Bactec Peds Plus/F, Bactec Plus Aerobic/F, BacT/Alert FA, and BacT/Alert PF bottles in detection of Candida spp. (P < 0.005, P < 0.05, P < 0.001, and P < 0.001, respectively). The present study showed that horse blood was the most effective supplement in growth of bacteria in the blood culture bottles that were analyzed in the study.
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Schultze D, Müller B, Bruderer T, Dollenmaier G, Riehm JM, Boggian K. A traveller presenting with severe melioidosis complicated by a pericardial effusion: a case report. BMC Infect Dis 2012; 12:242. [PMID: 23035948 PMCID: PMC3532095 DOI: 10.1186/1471-2334-12-242] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 10/01/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Burkholderia pseudomallei, the etiologic agent of melioidosis, is endemic to tropic regions, mainly in Southeast Asia and northern Australia. Melioidosis occurs only sporadically in travellers returning from disease-endemic areas. Severe clinical disease is seen mostly in patients with alteration of immune status. In particular, pericardial effusion occurs in 1-3% of patients with melioidosis, confined to endemic regions. To our best knowledge, this is the first reported case of melioidosis in a traveller complicated by a hemodynamically significant pericardial effusion without predisposing disease. CASE PRESENTATION A 44-year-old Caucasian man developed pneumonia, with bilateral pleural effusions and complicated by a hemodynamically significant pericardial effusion, soon after his return from Thailand to Switzerland. Cultures from different specimens including blood cultures turned out negative. Diagnosis was only accomplished by isolation of Burkholderia pseudomallei from the pericardial aspirate, thus finally enabling the adequate antibiotic treatment. CONCLUSIONS Melioidosis is a great mimicker and physicians in non-endemic countries should be aware of its varied manifestations. In particular, melioidosis should be considered in differential diagnosis of pericardial effusion in travellers , even without risk factors predisposing to severe disease.
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Affiliation(s)
- Detlev Schultze
- Center of Laboratory Medicine, Frohbergstrasse 3, CH-9001 St. Gallen, Switzerland
| | - Brigitt Müller
- Department of Internal Medicine, Cantonal Hospital, Rorschacherstrasse 95, CH-9007 St Gallen, Switzerland
| | - Thomas Bruderer
- Center of Laboratory Medicine, Frohbergstrasse 3, CH-9001 St. Gallen, Switzerland
| | - Günter Dollenmaier
- Center of Laboratory Medicine, Frohbergstrasse 3, CH-9001 St. Gallen, Switzerland
| | - Julia M Riehm
- Bundeswehr Institute of Microbiology, Neuherbergstr 11, D-80937, Munich, Germany
| | - Katia Boggian
- Department of Internal Medicine, Division of Infectious Diseases, Cantonal Hospital, Rorschacherstrasse 95, CH-9007 St Gallen, Switzerland
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Makhlouf HA, Morsy KH, Makhlouf NA, Eldin EN, Khairy M. Spontaneous bacterial empyema in patients with liver cirrhosis in Upper Egypt: prevalence and causative organisms. Hepatol Int 2012. [DOI: 10.1007/s12072-012-9372-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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27
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Van den Bossche D, de Haan R, Van der Werff Ten Bosch J, Van Hecke W, Symoens F, Van den Borre I, Allard S, De Bel A. Case report: Infrapatellar bursitis caused by Prototheca wickerhamii. Med Mycol Case Rep 2012; 1:13-6. [PMID: 24371726 DOI: 10.1016/j.mmcr.2012.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 03/13/2012] [Accepted: 03/15/2012] [Indexed: 10/28/2022] Open
Abstract
A 54-year-old immunocompetent man presented with an infrapatellar bursitis caused by Prototheca wickerhamii. Because of clinical and microbiological relapse two weeks after bursectomy, six weekly injections of 5 mg of conventional amphotericin B were chosen for intrabursal treatment. Four months after completion of the treatment, the patient remains cured.
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Affiliation(s)
- Dorien Van den Bossche
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Roel de Haan
- Department of Orthopedic Surgery and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Jutte Van der Werff Ten Bosch
- Department of Pediatric Hematology, Oncology and Immunology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Wim Van Hecke
- Department of Pathology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Françoise Symoens
- Mycology and Aerobiology Section, Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Ina Van den Borre
- Department of Clinical Pharmacology and Pharmacotherapy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Sabine Allard
- Department of Internal Medicine and Infectious Diseases, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Annelies De Bel
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
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Evaluation of growth based rapid microbiological methods for sterility testing of vaccines and other biological products. Vaccine 2011; 29:8012-23. [PMID: 21871516 DOI: 10.1016/j.vaccine.2011.08.055] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 08/04/2011] [Accepted: 08/10/2011] [Indexed: 11/22/2022]
Abstract
Most biological products, including vaccines, administered by the parenteral route are required to be tested for sterility at the final container and also at various stages during manufacture. The sterility testing method described in the Code of Federal Regulations (21 CFR 610.12) and the United States Pharmacopoeia (USP, Chapter <71>) is based on the observation of turbidity in liquid culture media due to growth of potential contaminants. We evaluated rapid microbiological methods (RMM) based on detection of growth 1) by adenosine triphosphate (ATP) bioluminescence technology (Rapid Milliflex(®) Detection System [RMDS]), and 2) by CO(2) monitoring technologies (BacT/Alert and the BACTEC systems), as alternate sterility methods. Microorganisms representing Gram negative, Gram positive, aerobic, anaerobic, spore forming, slow growing bacteria, yeast, and fungi were prepared in aliquots of Fluid A or a biological matrix (including inactivated influenza vaccines) to contain approximately 0.1, 1, 10 and 100 colony forming units (CFU) in an inoculum of 10 ml. These preparations were inoculated to the specific media required for the various methods: 1) fluid thioglycollate medium (FTM) and tryptic soy broth (TSB) of the compendial sterility method (both membrane filtration and direct inoculation); 2) tryptic soy agar (TSA), Sabouraud dextrose agar (SDA) and Schaedler blood agar (SBA) of the RMDS; 3) iAST and iNST media of the BacT/Alert system and 4) Standard 10 Aerobic/F and Standard Anaerobic/F media of the BACTEC system. RMDS was significantly more sensitive in detecting various microorganisms at 0.1CFU than the compendial methods (p<0.05), whereas the compendial membrane filtration method was significantly more sensitive than the BACTEC and BacT/Alert methods (p<0.05). RMDS detected all microorganisms significantly faster than the compendial method (p<0.05). BacT/Alert and BACTEC methods detected most microorganisms significantly faster than the compendial method (p<0.05), but took almost the same time to detect the slow growing microorganism P. acnes, compared to the compendial method. RMDS using SBA detected all test microorganisms in the presence of a matrix containing preservative 0.01% thimerosal, whereas the BacT/Alert and BACTEC systems did not consistently detect all the test microorganisms in the presence of 0.01% thimerosal. RMDS was compatible with inactivated influenza vaccines and aluminum phosphate or aluminum hydroxide adjuvants at up to 8 mg/ml without any interference in bioluminescence. RMDS was shown to be acceptable as an alternate sterility method taking 5 days as compared to the 14 days required of the compendial method. Isolation of microorganisms from the RMDS was accomplished by re-incubation of membranes with fresh SBA medium and microbial identification was confirmed using the MicroSEQ Identification System. BacT/Alert and BACTEC systems may be applicable as alternate methods to the compendial direct inoculation sterility method for products that do not contain preservatives or anti-microbial agents.
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Omer I, Hummeida MA, Musa HA. Improved Conventional Method for the Laboratory Diagnosis of Peritonitis from Peritoneal Dialysate in Sudan. Perit Dial Int 2011; 31:495-8. [DOI: 10.3747/pdi.2010.00147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ibtihal Omer
- Department of Microbiology National Ribat University Teaching Hospital Khartoum, Sudan
| | - Maha A. Hummeida
- Sudan Peritoneal Dialysis Program, Ribat Center National Ribat University Teaching Hospital Khartoum, Sudan
| | - Hassan A. Musa
- Department of Microbiology National Ribat University Teaching Hospital Khartoum, Sudan
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Sample taking during orthopedic surgery: sensitivity and specificity using the BACTEC blood culture system. Eur J Clin Microbiol Infect Dis 2011; 31:201-6. [DOI: 10.1007/s10096-011-1294-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2010] [Accepted: 02/20/2011] [Indexed: 10/18/2022]
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Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management--authors' responses. J Antimicrob Chemother 2011. [DOI: 10.1093/jac/dkr079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJC, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Surg Infect (Larchmt) 2010; 11:79-109. [PMID: 20163262 DOI: 10.1089/sur.2009.9930] [Citation(s) in RCA: 310] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates.
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Affiliation(s)
- Joseph S Solomkin
- Department of Surgery, the University of Cincinnati College of Medicine, 231 Albert B. Sabin Way, Cincinnati, OH 45267-0558, USA.
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Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and Management of Complicated Intra-abdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010; 50:133-64. [PMID: 20034345 DOI: 10.1086/649554] [Citation(s) in RCA: 974] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003–2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates.
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Affiliation(s)
- Joseph S. Solomkin
- Department of Surgery, the University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - John E. Mazuski
- Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri
| | | | - Keith A Rodvold
- Department of Pharmacy Practice, Chicago
- Department of Medicine, University of Illinois at Chicago, Chicago
| | - Ellie J.C. Goldstein
- R. M. Alden Research Laboratory, David Geffen School of Medicine at UCLA, Los Angeles
| | - Ellen J. Baron
- Department of Pathology, Stanford University School of Medicine, Palo Alto, California
| | - Patrick J. O'Neill
- Department of Surgery, The Trauma Center at Maricopa Medical Center, Phoenix, Arizona
| | - Anthony W. Chow
- Department of Medicine, University of British Columbia, Vancouver, British Columbia
| | | | | | - Sherwood Gorbach
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Mary Hilfiker
- Department of Surgery, Rady Children's Hospital of San Diego, San Diego
| | - Addison K. May
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | - John G. Bartlett
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Çetin ES, Kaya S, Demirci M, Aridogan BC. Comparison of the BACTEC blood culture system versus conventional methods for culture of normally sterile body fluids. Adv Ther 2007; 24:1271-7. [PMID: 18165209 DOI: 10.1007/bf02877773] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study compared the BACTEC blood culture system (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md) with conventional culture methods for recovery and time to detection of significant isolates from normally sterile body fluids. A total of 412 specimens were included in the study. Half of the specimens were inoculated directly into the automated blood culture system. The remaining specimens were centrifuged at 3000 rpm for 10 min and were inoculated onto conventional media. Clinically significant microorganisms were isolated from 41 specimens (10%) by both culture systems; however, for 62 specimens (14.9%), growth was detected only with the BACTEC system. No isolates were detected with only conventional culture methods. A significant difference was noted between the blood culture system and routine culture methods for recovery of pathogenic microorganisms that were from sterile body fluids. The most frequently isolated microorganisms recovered only with the blood culture system were gram-positive cocci; gram-negative bacilli were the most frequently isolated microorganisms that were recovered with both culture methods. Streptococcus pneumoniae, Streptococcus viridans, Aeromonas hydrophila, and Brucella were recovered only with the blood culture system. Furthermore, the mean time to detection of significant pathogens was significantly less with the blood culture system than with conventional media. The BACTEC blood culture system was found to improve the yield of clinically significant isolates from normally sterile body fluids with reduced time to detection; it may be advantageous for isolation of fastidious microorganisms, such as Brucella and S pneumoniae, especially from cerebrospinal and synovial fluid specimens.
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Thomas LC, Gidding HF, Ginn AN, Olma T, Iredell J. Development of a real-time Staphylococcus aureus and MRSA (SAM-) PCR for routine blood culture. J Microbiol Methods 2006; 68:296-302. [PMID: 17046087 DOI: 10.1016/j.mimet.2006.09.003] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Revised: 08/28/2006] [Accepted: 09/05/2006] [Indexed: 11/24/2022]
Abstract
The notification of "Gram-positive cocci, possibly staphylococcus" in a blood culture drawn from a seriously ill patient is responsible for a large amount of vancomycin prescribing in institutions where methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of bacteraemia. A duplex real-time TaqMan polymerase chain reaction targeting the species-specific nuc gene, and the mecA gene encoding methicillin-resistance, was developed as a tool for rapid identification and detection of S. aureus and methicillin-resistance, and optimised for immediate as-needs testing. Three different DNA extraction methods achieved varying DNA quality, with PCR inhibition the main problem. Serial blood cultures (n=120) identified as possible staphylococci on Gram stain from our clinical laboratory were examined. There was one false negative result for a methicillin-resistant Staphylococcus epidermidis, which was positive on repeat testing, and one false negative result due to DNA extraction failure for MRSA from peritoneal dialysate inoculated into blood culture medium. Sensitivity and specificity of 97% and 100%, respectively, were obtained for mecA; and sensitivity and specificity of 98% and 100%, respectively, for nuc. Detection of slow-growing coagulase-negative staphylococci as co-infecting strains may be reduced. The assay quickly and reliably identified S. aureus in mixed infection, and identified methicillin resistance in both S. epidermidis and S. aureus strains.
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Affiliation(s)
- L C Thomas
- Centre for Infectious Diseases and Microbiology-Public Health, University of Sydney, Australia
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Morency AM, Rallu F, Laferrière C, Bujold E. Eradication of Intra-Amniotic Streptococcus mutans in a Woman With a Short Cervix. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2006; 28:898-902. [PMID: 17140507 DOI: 10.1016/s1701-2163(16)32269-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Microbial invasion of the amniotic cavity (MIAC) remains an important pathogenetic factor in preterm births. Although most MIACs seem to originate in vaginal microflora, other reservoirs such as the oral microflora have been suggested. CASE We report a case of successful eradication of Streptococcus mutans (a bacterium generally found in dental plaque) from the amniotic cavity, using ampicillin, gentamycin, and azythromycin in a woman who presented with threatened preterm labour and a short cervix at 25 weeks' gestation. She delivered at 34 weeks' gestation and was treated for tooth decay 12 weeks after delivery. CONCLUSION Intra-amniotic infection should be suspected in the presence of a short cervix during the second trimester. Appropriate parenteral antibiotics can eradicate intra-amniotic infection and potentially prolong pregnancy.
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Affiliation(s)
- Anne-Maude Morency
- Department of Microbiology, Centre Hospitalier Universitaire-Hôpital Sainte-Justine, Université de Montréal, Montreal QC
| | - Fabien Rallu
- Department of Microbiology, Centre Hospitalier Universitaire-Hôpital Sainte-Justine, Université de Montréal, Montreal QC
| | - Céline Laferrière
- Department of Microbiology, Centre Hospitalier Universitaire-Hôpital Sainte-Justine, Université de Montréal, Montreal QC
| | - Emmanuel Bujold
- Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire-Hôpital Sainte-Justine, Université de Montréal, Montreal QC; Department of Obstetrics and Gynaecology, Faculté de médecine, Centre de recherche du CHUL, Centre Hospitalier Universitaire de Québec, Université Laval, Québec QC
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Aydoğan H, Basustaoğlu A, Yildiran ST, Küçükkaraaslan A, Yavuz Sanisoğlu S, Kubar A. Evaluation of blood culture bottles seeded with X-V factors for the detection of Neisseria meningitidis and Haemophilus influenzae. Microbiol Res 2005; 161:55-8. [PMID: 16338591 DOI: 10.1016/j.micres.2005.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2005] [Indexed: 11/25/2022]
Abstract
The purpose of this in vitro study was to determine the ability of seeded and not-seeded commercial pediatric blood culture bottles to support the growth of the most frequently responsible microorganisms for bacterial meningitides (Neisseria meningitidis, and Haemophilus influenzae). Tests have been carried out with an automated colorimetric pediatric blood culture system, BacTAlert, Organon Teknika. Bottles were inoculated with X-V factors and serial dilutions of the each bacterium in six times (10(1)-10(6) colony forming unit [CFU]/ml). The bottles, which were supplemented with X-V factors, proved to be effective and time to detection (TTD) was shorter than the un-seeded bottles (p0.05). Time difference between seeded and not-seeded bottles was getting greater at high dilutions of both bacteria. We consider that in presence of a few bacteria, the seeding of bottles with X-V factors is very critical obtaining N. meningitidis, and H. influenzae as the causative agents of meningitidis. The recovery rate of the microorganisms, which were isolated from cerebrospinal fluid by using the X-V factor-seeded blood culture bottles, is therefore higher than with the conventional culture methods.
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Affiliation(s)
- Hakan Aydoğan
- Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey.
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Kiang KM, Ogunmodede F, Juni BA, Boxrud DJ, Glennen A, Bartkus JM, Cebelinski EA, Harriman K, Koop S, Faville R, Danila R, Lynfield R. Outbreak of osteomyelitis/septic arthritis caused by Kingella kingae among child care center attendees. Pediatrics 2005; 116:e206-13. [PMID: 16024681 DOI: 10.1542/peds.2004-2051] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Kingella kingae often colonizes the oropharyngeal and respiratory tracts of children but infrequently causes invasive disease. In mid-October 2003, 2 confirmed and 1 probable case of K kingae osteomyelitis/septic arthritis occurred among children in the same 16- to 24-month-old toddler classroom of a child care center. The objective of this study was to investigate the epidemiology of K kingae colonization and invasive disease among child care attendees. METHODS Staff at the center were interviewed, and a site visit was performed. Oropharyngeal cultures were obtained from the staff and children aged 0 to 5 years to assess the prevalence of Kingella colonization. Bacterial isolates were subtyped by pulsed-field gel electrophoresis (PFGE), and DNA sequencing of the 16S rRNA gene was performed. A telephone survey inquiring about potential risk factors and the general health of each child was also conducted. All children and staff in the affected toddler classroom were given rifampin prophylaxis and recultured 10 to 14 days later. For epidemiologic and microbiologic comparison, oropharyngeal cultures were obtained from a cohort of children at a control child care center with similar demographics and were analyzed using the same laboratory methods. The main outcome measures were prevalence and risk factors for colonization and invasive disease and comparison of bacterial isolates by molecular subtyping and DNA sequencing. RESULTS The 2 confirmed case patients required hospitalization, surgical debridement, and intravenous antibiotic therapy. The probable case patient was initially misdiagnosed; MRI 16 days later revealed evidence of ankle osteomyelitis. The site visit revealed no obvious outbreak source. Of 122 children in the center, 115 (94%) were cultured. Fifteen (13%) were colonized with K kingae, with the highest prevalence in the affected toddler classroom (9 [45%] of 20 children; all case patients tested negative but had received antibiotics). Six colonized children were distributed among the older classrooms; 2 were siblings of colonized toddlers. No staff (n = 28) or children aged <16 months were colonized. Isolates from the 2 confirmed case patients and from the colonized children had an indistinguishable PFGE pattern. No risk factors for invasive disease or colonization were identified from the telephone survey. Of the 9 colonized toddlers who took rifampin, 3 (33%) remained positive on reculture; an additional toddler, initially negative, was positive on reculture. The children of the control child care center demonstrated a similar degree and distribution of K kingae colonization; of 118 potential subjects, 45 (38%) underwent oropharyngeal culture, and 7 (16%) were colonized with K kingae. The highest prevalence again occurred in the toddler classrooms. All 7 isolates from the control facility had an indistinguishable PFGE pattern; this pattern differed from the PFGE pattern observed from the outbreak center isolates. 16S rRNA gene sequencing demonstrated that the outbreak K kingae strain exhibited >98% homology to the ATCC-type strain, although several sequence deviations were present. Sequencing of the control center strain demonstrated more homology to the outbreak center strain than to the ATCC-type strain. CONCLUSIONS This is the first reported outbreak of invasive K kingae disease. The high prevalence in the affected toddler class and the matching PFGE pattern are consistent with child-to-child transmission within the child care center. Rifampin was modestly effective in eliminating carriage. DNA sequence analysis suggests that there may be considerable variability within the species K kingae and that different K kingae strains may demonstrate varying degrees of pathogenicity.
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Affiliation(s)
- Karen M Kiang
- Acute Disease Investigation and Control Section, Minnesota Department of Health, 717 Delaware St, SE, Minneapolis, MN 55414, USA
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Khuu HM, Stock F, McGann M, Carter CS, Atkins JW, Murray PR, Read EJ. Comparison of automated culture systems with a CFR/USP-compliant method for sterility testing of cell-therapy products. Cytotherapy 2004; 6:183-95. [PMID: 15203975 DOI: 10.1080/14653240410005997] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Although widely used, commercially available automated culture methods are not US Food and Drug Administration-approved for sterility testing of cell-therapy products. For cell-therapy products regulated under Section 351 of the Public Health Service Act, sterility testing must be performed by the methods described in 21 CFR 610.12 and USP <71> (CFR/USP method), or by methods demonstrated to be equivalent. METHODS Two automated methods, BacT/Alert (BTA; bioMerieux) and Bactec (Becton Dickinson), were compared with the CFR/USP method. Representative mononuclear cell (MNC) products were formulated using six different product media. MNC product aliquots containing 10-50 x 10(6) cells in a 0.5 mL volume were seeded with organisms, and cultured for 14 days in aerobic and anaerobic bottles of each system. Ten different organisms at target concentrations of 10 and 50 colony-forming units (CFU) per bottle were tested. RESULTS Positives were detected in a mean (range) of 72% (7-100%) of cultures for CFR/USP, 82% (0-100%) for BTA, and 93% (57-100%) for Bactec. For nine of the 10 organisms tested, overall detection rates for BTA and Bactec were equivalent to or higher than CFR/USP. Of the six product media tested, detection of organisms was impaired only by the medium containing multiple antibiotics: this occurred in all three systems. Both BTA and Bactec had shorter times to detection than the CFR/USP method, with overall means (ranges) of 87 (24-264) h for CFR/USP, 24 (12-54) h for BTA, and 33 (12-80) h for Bactec. Detection occurred consistently within 7 days for both BTA and Bactec, but not for CFR/USP. DISCUSSION Both BTA and Bactec are superior to the CFR/USP method for overall detection and time to detection of organisms in MNC products suspended in commonly used media. These data support general use of either BTA or Bactec for sterility testing of a variety of cell-therapy products, and suggest that a 7-day culture period is sufficient to detect clinically relevant organisms. These results confirm the need for bacteriostasis and fungistasis testing of antibiotic-containing products, even when antibiotic-binding substances are used.
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Affiliation(s)
- H M Khuu
- Department of Transfusion Medicine, National Institutes of Health, Bethesda, MD 20892, USA
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Marais E, Stewart R, Dusé AG, Rosekilly IC, de Jong G, Aithma N. Candida parapsilosis detected in TPN using the BacT/Alert system and characterized by randomly amplified polymorphic DNA. J Hosp Infect 2004; 56:291-6. [PMID: 15066740 DOI: 10.1016/j.jhin.2004.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2003] [Accepted: 01/07/2004] [Indexed: 11/25/2022]
Abstract
Candida parapsilosis was detected in environmental swabs and batches of total parenteral nutrition (TPN) products after routine monitoring. The isolates were analysed using randomly amplified polymorphic DNA (RAPD) to determine clonality and establish the most likely source of contamination. Of 20 isolates analysed, 18 were indistinguishable clonally and were found to be associated with particular work stations. The application of regular testing using a system such as the BacT/Alert, and molecular studies for epidemiological analysis, is of benefit to producers of medical products such as TPN to ensure patient safety.
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Affiliation(s)
- E Marais
- Department of Clinical Microbiology and Infectious Diseases, National Health Laboratory Services and University of the Witwatersrand, Johannesburg, PO Box 2115, Houghton 2041, South Africa.
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Hughes JG, Vetter EA, Patel R, Schleck CD, Harmsen S, Turgeant LT, Cockerill FR. Culture with BACTEC Peds Plus/F bottle compared with conventional methods for detection of bacteria in synovial fluid. J Clin Microbiol 2001; 39:4468-71. [PMID: 11724863 PMCID: PMC88567 DOI: 10.1128/jcm.39.12.4468-4471.2001] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An evaluation was undertaken to determine the utility of the BACTEC Peds Plus/F bottle and the BACTEC 9240 instrument (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md.) for the detection of clinically significant microorganisms in synovial fluid specimens. The Peds Plus/F bottle was used because in our laboratory the quantity of synovial fluid available for culture is frequently in the range of 0.5 to 3.0 ml. The culture results obtained with the Peds Plus/F bottle were compared to those obtained by a conventional agar plate method for a total of 805 synovial fluid specimens. Microbial growth was produced by 74 cultures (9.2%) from 60 patients, yielding a total of 77 microorganisms. Organisms were classified as pathogens (n = 62), contaminants (n = 12), or indeterminate (n = 3) on the basis of a review of the patients' medical histories. Culture using BACTEC Peds Plus/F bottle detected statistically significantly more pathogens overall (62 versus 51 pathogens [P = 0.001]) and statistically fewer contaminants overall (1 versus 11 contaminants [P = 0.006]) than culture by the agar plate method. These results indicate the superior performance of the BACTEC Peds Plus/F bottle over the conventional agar plate method for the detection of clinically significant microorganisms from synovial fluid specimens.
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Affiliation(s)
- J G Hughes
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Yagupsky P, Peled N, Press J. Use of BACTEC 9240 blood culture system for detection of Brucella melitensis in synovial fluid. J Clin Microbiol 2001; 39:738-9. [PMID: 11158139 PMCID: PMC87808 DOI: 10.1128/jcm.39.2.738-739.2001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Synovial fluid specimens aspirated from patients with arthritis were inoculated into an aerobic Peds Plus blood culture bottle and monitored by the BACTEC 9240 instrument for 4 weeks. A total of 1,072 synovial fluid cultures were processed, and 15 (0.14%) were positive for Brucella melitensis. A single culture, harboring 1.3 CFU of viable organisms per ml, was missed by the instrument. All 14 positive BACTEC cultures were detected within 3 to 7 days.
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Affiliation(s)
- P Yagupsky
- Clinical Microbiology Laboratories, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Simor AE, Scythes K, Meaney H, Louie M. Evaluation of the BacT/Alert microbial detection system with FAN aerobic and FAN anaerobic bottles for culturing normally sterile body fluids other than blood. Diagn Microbiol Infect Dis 2000; 37:5-9. [PMID: 10794933 DOI: 10.1016/s0732-8893(99)00157-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We evaluated the BacT/Alert Microbial Detection System (Organon Teknika Corporation, Durham, NC, USA) by using FAN bottles compared to conventional culture methods for the recovery of microorganisms from normally sterile body fluids other than blood and dialysates. Clinically significant pathogens were isolated from 116 (11%) of 1, 099 consecutive specimens (80 from both conventional media and FAN bottles; 23 from FAN bottles only; 13 from conventional media only). Gram-positive cocci were more likely to be recovered from FAN bottles than from conventional media (p = 0.04). Contaminants were also more likely to have grown in FAN bottles (3%) than on conventional media (1%) (p = 0.04). The mean time to detection of significant pathogens was 20.9 h using FAN bottles as compared to 30. 9 h using conventional media (p = 0.0001). These results indicate that the BacT/Alert Microbial Detection System using FAN blood culture bottles improves the yield of clinically significant Gram-positive isolates from normally sterile body fluids with a reduced time to detection.
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Affiliation(s)
- A E Simor
- Department of Microbiology, SD Laboratory Services, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario, Canada.
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