The FilmArray platform (FA; BioFire, Salt Lake City, UT) is a closed diagnostic system allowing high-order multiplex PCR analysis with automated readout of results directly from positive blood cultures in 1 h. In the present study, we evaluated the clinical performance of the FilmArray blood culture identification (BCID) panel, which includes 19 bacteria, five yeasts, and three antibiotic resistance genes. In total, 206 blood culture bottles were included in the study. The FilmArray could identify microorganisms in 153/167 (91.6%) samples with monomicrobial growth. Thirteen of the 167 (7.8%) microorganisms were not covered by the FilmArray BCID panel. In 6/167 (3.6%) samples, the FilmArray detected an additional microorganism compared to blood culture. When polymicrobial growth was analyzed, the FilmArray could detect all target microorganisms in 17/24 (71%) samples. Twelve blood culture bottles that yielded a positive signal but showed no growth were also negative by FilmArray. In 3/206 (1.5%) bottles, the FilmArray results were invalid. The results of the FilmArray were reproducible, as demonstrated by the testing and retesting of five bottles in the same day and a longitudinal follow-up of five other blood cultures up to 4 weeks. The present study shows that the FilmArray is a rapid identification method with high performance in direct identification of bacteria and yeasts from positive blood culture bottles.

Propolis (bee glue) is a bee glue, sticky resinous material released from various plant sources such as bud exudates, flowers, and leaves modified by bee secretions and wax propolis is composed of resins, waxes, polyphenols, polysaccharides, volatile materials, and secondary metabolites that are responsible for various bioactivity such as antibacterial, anti-angiogenic, antiulcer, anti-inflammatory, antioxidant, and anti-viral activities. The physico-chemical characteristics and the natural properties of various kinds of propolis have been studied for the past decade. Novel active anti-microbial compounds have been identified in propolis. Those compounds positively modulated the antimicrobial resistance of multidrug resistant bacteria. Published research has indicated that propolis and its derivatives has many natural antimicrobial compounds with a broad spectrum against different types of bacteria and that it enhanced the efficacy of conventional antibiotics. Besides, the combination of propolis with other compounds such as honey has been studied whereby, such combinations have a synergistic effect against bacterial strains such as Escherichia coli and Staphylococcus aureus . The activity of propolis is very much dependent on seasonal and regional factors, and Middle Eastern propolis have shown best antibacterial efficacy. Propolis and its main flavonoids ingredients should not be overlooked and should be evaluated in clinical trials to better elucidate their potential application in various fields of medicine. Clinical antibacterial potential and its use in new drugs of biotechnological products should be conducted. This review aims at highlighting some of the recent scientific findings associated with the antibacterial properties of propolis and its components.

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cWe compared the newly approved BacT/Alert Virtuo blood culture system to the BacT/Alert 3D system using 115 clinical bacterial and fungal isolates in 784 simulated blood culture bottles. The time to detection was reduced by roughly 20% in the Virtuo system (P < 0.0001) while the detection rate did not differ. Bloodstream infections remain a leading cause of death and are associated with high mortality and morbidity (1, 2). Early intervention and initiation of appropriate treatment have been shown to improve patient outcome (3-5). Rapid detection and identification of the causing pathogen are therefore essential in the diagnosis of these invasive diseases.Blood culture (BC) is the gold standard for detection of bacteria and fungi from blood or other normally sterile body fluids. It has previously been shown that the type of BC bottle used has a substantial impact on the microbiological diagnosis of bloodstream infections (6-10), as these media are complex formulations that provide nutrients and neutralizing antimicrobials in clinical blood samples (11). In addition, the BC system affects workflow and microbiological performance (11,12). To date, the most widely distributed BC systems are the BacT/Alert 3D (bioMérieux; referred to as 3D hereafter), BD Bactec (Becton Dickinson), and VersaTREK (Thermo Scientific). bioMérieux has recently introduced a new BC system with automatic loading and unloading of BC bottles, the BacT/ Alert Virtuo (Virtuo), for bacterial and fungal detection in BC. Enhanced colorimetric technology to detect microbial growth and improved temperature stability suggest improved culture conditions in the Virtuo compared to the 3D system. However, the microbiological performance of Virtuo has not been evaluated.In this study, the Virtuo system was tested in direct comparison with the 3D system by parallel incubation of a total of 115 clinical bacterial and fungal isolates (Table 1). All isolates were originally collected from clinical BC samples sent for microbiological diagnosis to Karolinska University Laboratory (Stockholm, Sweden) from three tertiary care hospitals in the greater Stockholm area. Isolates were recovered from frozen stocks and were cultured overnight on appropriate agar medium. Approximately 15 CFU in phosphate-buffered saline was inoculated into each BC bottle with 8 ml defibrinated horse blood, and all BC bottles were incubated until positivity was reached or for a maximum of 5 days. We and others have previously demonstrated that the use of horse blood does not significantly influence the performance of BC systems (13-17). Growth was assessed in aerobic (FA and FA Plus) and anaerobic (FN and FN Plus) BacT/Alert BC bottles, except for Acinetobacter spp. and Candida spp., which were cultured under aerobic conditions only. While the CE-approved version of the Virtuo system is intended to operate with resin-based BC bottles (FA Plus and FN Plus) only, charcoal-based BC bottles (FA and FN) were evaluated in the 3D system and in the investigational-use-only version of Virtuo emplo...

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Early detection and rapid identification of microorganisms are crucial the for appropriate management of infections of normally sterile body fluids (SBF) (1-3). Previously, SBF other than blood were cultured on solid medium (4). Larger volumes were processed through centrifugation and filtration in order to concentrate and improve the detection of microorganisms. Nonetheless, the microorganism recovery from SBF was unsatisfactory until the introduction of blood culture (BC) bottles. The introduction of BC bottles resulted in increased microorganism recovery in addition to decreased time to detection (5-10). However, the identification of microorganisms from positive bottles with conventional methods may still take up to 48 h for many microorganisms and even longer for others, such as slow-growing bacteria and yeasts (11). Several methods have been evaluated for rapid identification of microorganisms directly from positive blood cultures (12)(13)(14). In contrast, the data on the performance of rapid microbiological methods in diagnostics of SBF are scarce. The aim of the present study was to evaluate the performance of the FilmArray blood culture identification (BCID) panel in the identification of microorganisms directly from positive blood culture bottles inoculated with clinical SBF specimens.This study was performed at Karolinska University Hospital, Huddinge, Sweden. SBF specimens were collected in the clinical wards using standard protocols. Specimen volumes of 1 to 2 ml were inoculated in BacT/Alert pediatric/PF plus (bioMérieux, Durham, NC, USA), and volumes of Ͼ2 ml in BacT/Alert aerobic/FA plus and anaerobic/FN plus bottles (bioMérieux). All bottles were incubated in the BacT/Alert 3D blood culture system (bioMérieux) until they gave a positive signal or for a maximum incubation time of 5 days.Positive BC bottles with SBF were processed as follows. Gram staining was performed immediately after bottles signaled positivity. All positive bottles were subcultured onto a Columbia blood agar plate (aerobic and anaerobic), a cystinelactose-electrolyte-deficient plate (CLED) agar, and a chocolate agar plate. After an incubation time of 48 h, we analyzed the growth morphology on the agar plates. Identification of microorganisms was done by conventional methods, including matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS; Bruker Daltonics, Bremen, Germany) and Vitek2 XL (bioMérieux). Susceptibility testing was performed by the disc diffusion method according to EUCAST guidelines (http://www.eucast.org/). Methicillin resistance in Staphylococcus spp. was evaluated by the cefoxitin disc diffusion method. Similarly, imipenem and meropenem disc diffusion methods were used in order to determine/confirm the absence of Klebsiella pneumoniae carbapenemase (KPC). FilmArray (FA; bioFire, Salt Lake City, UT) analyses were performed as previously described (13). Results that were discrepant between the reference method and the FilmArray were evaluated further. According to the discre...

Detection and identification of anaerobic bacteria in blood cultures (BC) is a well-recognized challenge in clinical microbiology. We studied 100 clinical anaerobic BC isolates to evaluate the performance of BacT/ALERT-FN, -FN Plus (BioMérieux), BACTEC-Plus and -Lytic (Becton Dickinson BioSciences) BC bottles in detection and time to detection (TTD) of anaerobic bacteria. BACTEC Lytic had higher detection rate (94/100, 94%) than BacT/ALERT FN Plus (80/100, 80%) (p<0.01) in the studied material. There was no significant difference in detection of anaerobic bacteria among the remaining bottle types. The 67 anaerobic bacteria that signalled positive in all four bottle types were analyzed to compare the time to detection (TTD) and isolates were directly identified by MALDI-TOF MS. There was a significant difference in TTD among the four bottle types (p<0.0001). The shortest median TTD was 18 h in BACTEC Lytic followed by BacT/ALERT FN (23.5 h), BACTEC Plus (27 h) and finally BacT/ALERT FN Plus (38 h) bottles. In contrast, MALDI-TOF MS performed similarly in all bottle types with accurate identification in 51/67 (76%) BacT/ALERT FN, 51/67 (76%) BacT/ALERT FN Plus, 53/67 (79%) BACTEC Plus and 50/67 (75%) BACTEC Lytic bottles. In conclusion, BACTEC Lytic bottles have significantly better detection rates and shorter TTD compared to the three other bottle types. The anaerobic BC bottles are equally suitable for direct MALDI-TOF MS for rapid and reliable identification of common anaerobic bacteria. Further clinical studies are warranted to investigate the performance of anaerobic BC bottles in detection of anaerobic bacteria and identification by direct MALDI-TOF MS.