Reassessment of the incubation time in a controlled clinical comparison of the BacT/Alert aerobic FAN bottle and standard anaerobic bottle used aerobically for the detection of bloodstream infections

Cornish, Nancy E.; Kirkley, Barbara A.; Easley, Kirk A.; Washington, John A.

doi:10.1016/s0732-8893(98)00057-1

Cited by 22 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This practice of routine use of paired aerobic and anaerobic blood culture bottles was challenged in a series of articles which noted a relative decline in the number of isolates of obligate anaerobic bacteria and a concomitant increase in the number of isolates of obligate aerobic or facultative anaerobic bacteria and yeasts (1,2,8,9,12). Specifically, in 1991, Sharp questioned whether routine anaerobic blood cultures were still appropriate (11).…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, in 1991, Sharp questioned whether routine anaerobic blood cultures were still appropriate (11). Others have advocated the selective use of anaerobic blood cultures, restricting them to patients with specific illnesses or diseases or undergoing specific procedures such as colorectal or gynecological surgery (1,2,8,9,12). Indeed, the topic of whether an anaerobic blood culture should routinely be performed was the subject of several articles and editorials in the medical literature (6,7,10).…”

Section: Discussionmentioning

confidence: 99%

“…Cornish and colleagues, in an analysis of the data collected from the use of FAN aerobic and standard BacT/ALERT blood culture bottles, advocated the selective use of an unvented anaerobic bottle based upon patient location and disease service (2). Subsequently, in another study, these same authors compared the performance of standard BacT/ALERT anaerobic blood culture bottles with the FAN anaerobic blood culture bottles (3).…”

Section: Discussionmentioning

confidence: 99%

“…Beginning with a report by Sharp (11), a number of publications have challenged the need for the use of a routine anaerobic blood culture bottle, essentially asking whether the inoculation of the same volume of blood into two aerobic blood culture bottles, at least on a selective basis, would be more clinically beneficial than the use of the more traditionally employed aerobic-anaerobic pair (1,2,8,9,12).…”

mentioning

confidence: 99%

See 3 more Smart Citations

Comparison of Recovery of Blood Culture Isolates from Two BacT/ALERT FAN Aerobic Blood Culture Bottles with Recovery from One FAN Aerobic Bottle and One FAN Anaerobic Bottle

2003

View full text Add to dashboard Cite

Traditionally, a routine blood culture for adult patients consisted of paired aerobic and anaerobic bottles, but the routine use of an anaerobic blood culture bottle has been challenged in recent years. In this study, we compared the recovery of two FAN aerobic bottles with one FAN aerobic and one FAN anaerobic bottle. Each pair of bottles was collected by a separate collection procedure, and each bottle held a recommended 8-to 12-ml draw. A total of 704 clinically significant isolates were recovered from 8,620 sets (17,240 pairs), with 487 (69.2%) isolates recovered from one or both bottles in each pair of bottles, 86 isolates (12.2%) recovered only from the FAN aerobic-FAN aerobic pair, and 131 isolates (18.6%) recovered only from the FAN aerobic-FAN anaerobic pair. Significantly more total organisms (P ‫؍‬ 0.002), gram-positive cocci (P ‫؍‬ 0.03), Staphylococcus aureus (P ‫؍‬ 0.05), Enterobacteriaceae other than Escherichia coli (P ‫؍‬ 0.02), and anaerobes (P ‫؍‬ 0.01) were recovered from the FAN aerobic-FAN anaerobic pair than from the FAN aerobic-FAN aerobic pair. A separate analysis was performed on the 618 isolates that were recovered from the FAN aerobic-FAN anaerobic pair to compare recovery by bottle type. Significantly more S. aureus (P ‫؍‬ 0.005) and anaerobes (P < 0.001) were recovered from the FAN anaerobic bottle, while significantly more coagulase-negative staphylococci (P ‫؍‬ 0.01), Streptococcus pneumoniae (P ‫؍‬ 0.03), and other gram-negative bacilli (P ‫؍‬ 0.004) were recovered from the FAN aerobic bottle. These results support the routine use of a FAN anaerobic bottle for use in the culture of blood with the BacT/ALERT system in our institution. These results also suggest that the decision of whether to routinely utilize an anaerobic blood culture bottle should be influenced by the overall recovery of bacteria and yeast, the recovery of specific types of bacteria or yeast, the medium type, and the blood culture system utilized by the laboratory.Traditionally, in most clinical microbiology laboratories in the United States, a routine blood culture for adults has consisted of paired aerobic and anaerobic blood culture bottles. Depending upon the methodology and bottle type employed, the volume of blood placed into each bottle has generally ranged from 3 to 10 ml for adult patients.Beginning with a report by Sharp (11), a number of publications have challenged the need for the use of a routine anaerobic blood culture bottle, essentially asking whether the inoculation of the same volume of blood into two aerobic blood culture bottles, at least on a selective basis, would be more clinically beneficial than the use of the more traditionally employed aerobic-anaerobic pair (1,2,8,9,12).Implicit in the argument to restrict the use of anaerobic blood culture bottles is the premise that were the same amount of blood inoculated into a second aerobic bottle rather than an anaerobic bottle, the overall yield would be greater with two aerobic bottles than with the aerobic-anaerobic pair. The purpose of th...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Recovery of Blood Culture Isolates from Two BacT/ALERT FAN Aerobic Blood Culture Bottles with Recovery from One FAN Aerobic Bottle and One FAN Anaerobic Bottle

2003

View full text Add to dashboard Cite

show abstract

“…A 4-day incubation period has been shown to be acceptable for each of the three major blood culture instruments (7,8,15), though a shortened incubation time would not be acceptable if the BT agent was either F. tularensis or Brucella species. For example, although blood cultures have been flagged as positive in Ͻ11 h by a continuously monitoring blood culture system for a patient with fatal F. tularensis bacteremia (21), the standard recommendation when F. tularensis is suspected is to hold cultures for a minimum of 14 days and to perform blind subcultures onto an enriched medium every 3 to 5 days, even with continuously monitoring blood culture systems (9).…”

Section: Discussionmentioning

confidence: 99%

Surge Capacity for Response to Bioterrorism in Hospital Clinical Microbiology Laboratories

Shapiro

2003

J Clin Microbiol

View full text Add to dashboard Cite

Surge capacity is the ability to rapidly mobilize to meet an increased demand. While large amounts of federal funding have been allocated to public health laboratories, little federal funding has been allocated to hospital microbiology laboratories. There are concerns that hospital laboratories may have inadequate surge capacities to deal with a significant bioterrorism incident. A workflow analysis of a clinical microbiology laboratory that serves an urban medical center was performed to identify barriers to surge capacity in the setting of a bioterrorism event and to identify solutions to these problems. Barriers include a national shortage of trained medical technologists, the inability of clinical laboratories to deal with a dramatic increase in the number of blood cultures, a delay while manufacturers increase production of critical products and then transport and deliver these products to clinical laboratories, and a shortage of class II biological safety cabinets. Federal funding could remedy staffing shortages by making the salaries of medical technologists comparable to those of similarly educated health care professionals and by providing financial incentives for students to enroll in clinical laboratory science programs. Blood culture bottles, and possibly continuous-monitoring blood culture instruments, should be added to the national antibiotic stockpile. Federal support must ensure that companies that manufacture essential laboratory supplies are capable of rapidly scaling up production. Hospitals must provide increased numbers of biological safety cabinets and amounts of space dedicated to clinical microbiology laboratories. Laboratories should undertake limited cross-training of technologists, ensure that adequate packaging supplies are available, and be able to move to a 4-day blood culture protocol.Surge capacity, the ability to rapidly respond to a sudden and dramatic increase in needs, has historically been addressed in the military as one component of readiness and in the civilian emergency preparedness setting to meet the needs of the population in response to natural disasters. The provision of medical services in the setting of a terrorist event is another scenario in which surge capacity must be adequate.In the setting of a bioterrorism (BT) event, plans in place have increased the surge capacity of the public health and emergency medical system to deal with the diverse needs of the population. These plans include increasing the ability of the United States to rapidly deliver large quantities of antibiotics, vaccines, antitoxins, and ventilators from the national antibiotic stockpile and manufacturing sufficient smallpox vaccine to vaccinate the U.S. population. Plans to enable first responders and emergency departments to mobilize in a timely manner to deal with a tremendous increase in the demand for their services are also in place. There are significant costs associated with the maintenance of surge capacity.Although large amounts of federal funding have been allocated to laboratorie...

show abstract

Commercial Methods for Identification and Susceptibility Testing of Fungi

Moser

Wicker

2016

Manual of Commercial Methods in Clinical Microbiology

View full text Add to dashboard Cite

Reassessment of the incubation time in a controlled clinical comparison of the BacT/Alert aerobic FAN bottle and standard anaerobic bottle used aerobically for the detection of bloodstream infections

Cited by 22 publications

References 15 publications

Comparison of Recovery of Blood Culture Isolates from Two BacT/ALERT FAN Aerobic Blood Culture Bottles with Recovery from One FAN Aerobic Bottle and One FAN Anaerobic Bottle

Comparison of Recovery of Blood Culture Isolates from Two BacT/ALERT FAN Aerobic Blood Culture Bottles with Recovery from One FAN Aerobic Bottle and One FAN Anaerobic Bottle

Surge Capacity for Response to Bioterrorism in Hospital Clinical Microbiology Laboratories

Commercial Methods for Identification and Susceptibility Testing of Fungi

Contact Info

Product

Resources

About