Effectiveness of Resins in Neutralizing Antibiotic Activities in Bactec Plus Aerobic/F Culture Medium

Spaargaren, Joke; Boven, C. P. A. van; Voorn, G. Paul

doi:10.1128/jcm.36.12.3731-3733.1998

Cited by 49 publications

(17 citation statements)

References 20 publications

(24 reference statements)

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“…To minimize this risk, blood culture bottles containing proprietary binding resins that inactivate residual concentrations are available. However, these bottles and their binding resins perform differently based on the specific organisms and antimicrobials being combined (6)(7)(8)(9)(10). Lovern and colleagues observed differences in binding affinities for antibiotics across several classes, including ␤-lactams, fluoroquinolones, and glycopeptides, and these differences translated into the ability for BSI organisms to grow and be identified (11).…”

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confidence: 99%

Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

2019

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Blood culture bottles containing antibiotic binding resins are routinely used to minimize artificial sterilization in the presence of antibiotics. However, the resin binding kinetics can differ between antibiotics and concentrations. This study assessed the impact of clinically meaningful peak, midpoint, and trough concentrations of meropenem, imipenem, cefepime, cefazolin, levofloxacin, and piperacillin-tazobactam on the recovery of Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae from resin-containing BacT/Alert FA Plus and Bactec Aerobic/F blood culture bottles. P. aeruginosa-inoculated bottles alarmed positive in 4/20 (20%), 16/20 (80%), and 20/20 (100%) of those with peak, midpoint, and trough concentrations of antipseudomonal agents, respectively (P ≤ 0.001). E. coli was recovered from 8/24 (33%), 11/24 (46%), and 14/24 (58%) of bottles with peak, midpoint, and trough concentrations, respectively (P = 0.221). K. pneumoniae was recovered from 8/16 (50%) at all concentrations of the studied antibiotics (P = 1.0). BacT/Alert and Bactec bottles inoculated with antibiotics and P. aeruginosa had similar times to detection (TTD) (P = 0.352); however, antibiotic-containing BacT/Alert bottles had a shorter TTD compared with antibiotic-containing Bactec bottles for E. coli (P = 0.026) and K. pneumoniae (P ≤ 0.001). Pathogen recovery in BacT/Alert FA Plus and Bactec Aerobic/F blood culture bottles containing antibiotic binding resins was greatly reduced in the presence of antibiotics, especially at higher concentrations. These data support the practice of drawing blood cultures immediately before an antibiotic dose to maximize the chances of pathogen recovery.

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Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

2019

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“…to prevent artificial sterilization of the sample (6)(7)(8)(9)(10)(11). In vitro and clinical studies have suggested variability in performances for different combinations of microorganisms, antibiotics, and binding systems (6)(7)(8)(9)(10)(11)(12). For example, Zadroga and colleagues (12) observed the recovery of Gram-negative bacteria in Becton Dickinson Bactec Plus BC bottles when piperacillin-tazobactam was administered prior to collection, while cultures from the same patients using bioMérieux BacT/Alert FAN bottles demonstrated residual piperacillin concentrations above the MIC, with no recovery.…”

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Effects of Clinically Meaningful Concentrations of Antipseudomonal β-Lactams on Time to Detection and Organism Growth in Blood Culture Bottles

et al. 2017

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The effectiveness of antimicrobial binding resins present in blood culture (BC) bottles in removing meropenem, ceftolozane-tazobactam, and ceftazidime-avibactam is unknown. We assessed the time to detection (TTD) and growth of 2 isolates in the presence of clinically meaningful concentrations of these antibiotics. Bactec Plus Aerobic/F and BacT/Alert FA Plus BC bottles were inoculated with one of two isolates (1 meropenem susceptible and 1 resistant), followed by fresh whole blood containing the peak, midpoint, or trough plasma concentrations for meropenem, ceftolozane-tazobactam, and ceftazidime-avibactam. Matching bottles were loaded into their respective detection instruments and a standard incubator at 37°C, with TTD and CFU being monitored for up to 72 h. Bacterial growth was observed for 11/48 (22.9%), 22/48 (45.8%), and 47/48 (97.9%) of all BC bottles inoculated with the peak, midpoint, and trough concentrations, respectively ( ≤ 0.001). When was isolated, the TTD was typically<26 h, and no differences between Bactec and BacT/Alert bottles were observed. In both systems, meropenem was removed to a greater degree than were ceftolozane and ceftazidime; however, concentrations for all antibiotics remained above the MIC for the susceptible organisms at 12 h. BC bottles containing antibiotic binding resins may not sufficiently inactivate achievable concentrations of meropenem, ceftolozane-tazobactam, and ceftazidime-avibactam. The consistent identification of both isolates was observed only in the presence of antibiotic trough concentrations. To minimize false-negative BC results for patients already receiving these antibiotics, cultures should be collected just prior to the next dose, when antibiotic concentrations are lowest.

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“…Culture media used with automated systems usually contain inhibitors for a broad range of antibiotics that reduce but do not eliminate the risk of false‐negative results 9,26‐29. In this context, the ratio of antimicrobial plasma in the inoculum as well as the delay between collection of the CB and inoculation of culture bottles must be taken into account by CB banks when validating their sterility method since these factors might reduce the survival of contaminating bacteria in tested CB samples and therefore contribute to false‐negative results.…”

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confidence: 99%

Antimicrobial activity in cord blood units: occurrence and levels of antibiotics

et al. 2014

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Effectiveness of Resins in Neutralizing Antibiotic Activities in Bactec Plus Aerobic/F Culture Medium

Cited by 49 publications

References 20 publications

Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

Effects of Clinically Meaningful Concentrations of Antipseudomonal β-Lactams on Time to Detection and Organism Growth in Blood Culture Bottles

Antimicrobial activity in cord blood units: occurrence and levels of antibiotics

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