Controlled Clinical Comparison of BACTEC Plus Anaerobic/F to Standard Anaerobic/F as the Anaerobic Companion Bottle to Plus Aerobic/F Medium for Culturing Blood from Adults

Abstract

To determine the optimal anaerobic companion bottle to pair with BACTEC Plus Aerobic/F medium for recovery of pathogenic microorganisms from adult patients with bacteremia and fungemia, we compared Plus Anaerobic/F bottles with Standard Anaerobic/F bottles, each of which was filled with 4 to 6 ml of blood. The two bottles were paired with a Plus Aerobic/F bottle filled with 8 to 12 ml of blood. A total of 14,011 blood culture sets were obtained. Of these, 11,583 sets were received with all three bottles filled adequately and 12,257 were received with both anaerobic bottles filled adequately. Of 818 clinically important isolates detected in one or both adequately filled anaerobic bottles, significantly more staphylococci (P < 0.001), streptococci (P < 0.005), Escherichia coli isolates (P < 0.02), Klebsiella pneumoniae isolates (P < 0.005), and all microorganisms combined (P < 0.001) were detected in Plus Anaerobic/F bottles. In contrast, significantly more anaerobic gram-negative bacilli were detected in Standard Anaerobic/F bottles (P < 0.05). Of 397 unimicrobial episodes of septicemia, 354 were detected with both pairs, 30 were detected with Plus Aerobic/F-Plus Anaerobic/F pairs only, and 13 were detected with Plus Aerobic/F-Standard Anaerobic/F pairs only (P < 0.05). Significantly more episodes of bacteremia caused by members of the family Enterobacteriaceae (P < 0.05) and aerobic and facultative gram-positive bacteria (P < 0.025) were detected with Plus Anaerobic/F bottles only. In a pairedbottle analysis, 810 of 950 isolates were recovered from both pairs, 90 were recovered from Plus Aerobic/F-Plus

Clinical Evaluation of BacT/Alert FA Plus and FN Plus Bottles Compared with Standard Bottles

“…The comparison study of the Bactec Plus Anaerobic/F versus SN bottles showed the same result (8). There was no difference in the skin contamination rate between the resin bottles and the standard bottles in this study.…”

“…The mean TTD for the FN Plus bottles was similar to that for the SN Plus bottles. The TTD for the SN bottles was shorter than that for the FN charcoal bottles in a previous study (8). We may conclude that the TTD was shorter in the FA Plus bottles than in the SA bottles but that the TTDs were equivalent for the FN Plus and SN bottles.…”

“…This pattern was similarly observed in the comparison of the FA bottles (charcoal) versus the SA bottles (7), the comparison of the FN bottles (charcoal) versus the SN bottles (8), and in the comparison involving all the bottles (4). Staphylococcus aureus, CoNS, and yeast were more significantly isolated in the FA (charcoal) bottles than in the SA bottles in a study by Weinstein et al (9).…”

“…Some authors have suggested better performance by resincontaining Bactec Plus (BD Diagnostic Systems, Sparks, MD) bottles than by 3D charcoal-containing FAN bottles (3,8,10). Charcoal-containing FAN bottles appear to be less sensitive than BD Plus bottles, and it is difficult to interpret the Gram staining results.…”

Update on blood cultures: how to obtain, process, report, and interpret

“…In the vast majority of institutions, most blood culture specimens delivered to the laboratory are entered into an incubation protocol on a continuously monitored blood culture device. There are several manufacturers of such devices, and their performance characteristics are similar [27][28][29][30][31][32][33][34][35]. These devices incubate the blood culture bottles for a prescribed period of time (determined by the user) and signal audibly and/or visually if growth is detected.…”