The Use of Penicillinase in Cultures of Body Fluids Obtained From Patients Under Treatment With Penicillin

Dowling, Harry F.; Hirsh, Harold L.

doi:10.1097/00000441-194512000-00008

Cited by 13 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The following indicators of positivity prompted a Gram smear of uncentrifuged blood culture fluid: macroscopic evidence of growth, a growth index of -20 U, or an incremental increase of -5 growth index units over the previous reading. If Gram smears of macroscopically or radiometrically positive bottles were negative, blind subcultures of uncentrifuged blood culture fluid were performed with enriched chocolate agar incubated at 35°C in 5 to 7% CO2 for 48 h and brucella agar base containing 5% sheep blood, vitamin K, and hemin incubated anaerobically at 35°C for 48 h.…”

Section: Methodsmentioning

confidence: 99%

Detection of bacteremia in patients receiving antimicrobial therapy: an evaluation of the antimicrobial removal device and 16B medium

Doern¹,

Gantz²

1983

J Clin Microbiol

View full text Add to dashboard Cite

A total of 1097 blood specimens obtained from patients receiving antibacterial antimicrobial agents were processed by three blood culture systems: standard aerobic and anaerobic radiometric media, resin-containing radiometric medium (16B; Johnston Laboratories, Cockeysville, Md.), and aerobic and anaerobic radiometric media inoculated with blood processed in an Antimicrobial Removal Device (Marion Laboratories, Kansas City, Mo.). A total of 73 cultures, representing 45 unique septic episodes, yielded 81 clinically significant organisms. Forty-six organisms (28 septic episodes) were recovered in standard radiometric medium. 16B medium yielded 63 organisms (37 septic episodes). Sixty-nine organisms (42 septic episodes) were isolated from radiometric blood cultures inoculated with Antimicrobial Removal Device-processed blood. Contamination rates were not significantly different among the three systems. In comparison with standard radiometric blood cultures, the length of time to detection of positive blood cultures was shorter with both 16B medium and with Antimicrobial Removal Device-processed cultures. Comparison of the latter two systems suggested enhanced recovery of clinically significant organisms in radiometric blood cultures inoculated with blood processed in the Antimicrobial Removal Device. There was no difference in the length of time to detection of positive blood cultures.

show abstract

Section: Methodsmentioning

confidence: 99%

Detection of bacteremia in patients receiving antimicrobial therapy: an evaluation of the antimicrobial removal device and 16B medium

Doern¹,

Gantz²

1983

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…Concerns about the inability to recover a pathogen due to antibiotic therapy are well documented in the literature. In 1945, Dowling and Hirsh (8) published an article about the use of penicillinase in cultures of body fluids obtained from patients undergoing treatment with penicillin. In 1963, a review article in the Journal of the American Medical Association demonstrated the unmasking of false-negative blood cultures in patients receiving new penicillins when penicillinase produced by Bacillus cereus was added to blood cultures (6).…”

mentioning

confidence: 99%

Comparison of BACTEC PLUS Blood Culture Media to BacT/Alert FA Blood Culture Media for Detection of Bacterial Pathogens in Samples Containing Therapeutic Levels of Antibiotics

et al. 2007

View full text Add to dashboard Cite

Blood culture bottles with antimicrobial removal systems are recommended for patients who develop fever while on antibiotics. This study compared the ability of Becton Dickinson (Sparks, MD) BACTEC PLUS bottles and bioMerieux (Durham, NC) BacT/Alert FA bottles to effectively remove vancomycin, cefoxitin, ceftriaxone, cefepime, piperacillin-tazobactam, ampicillin, oxacillin, gentamicin, and a combination of gentamicin/penicillin, thus allowing bacterial pathogens to grow. Each bottle was spiked with 10 ml of human blood, antibiotic, and strains of organisms susceptible to the antibiotic evaluated. The organisms used were type strains and clinical isolates of Staphylococcus aureus (methicillin susceptible and resistant), Streptococcus pneumoniae, a viridans streptococcus, Enterococcus faecalis, Enterococcus faecium, Streptococcus agalactiae, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Testing was completed in triplicate, using 10 to 100 CFU/ml of organisms with various concentrations of each antibiotic. Two rounds of testing were completed per antibiotic/organism combination. Bottles were mixed and loaded onto their respective instruments as per the manufacturer's instructions. Antimicrobial removal was evaluated on the basis of time to detection of organism growth, for up to 5 days of incubation. Overall, the BacT/Alert FA system recovered 25.1% of strains from test bottles and 96.9% of strains from growth control bottles (no antibiotic added), and the BACTEC PLUS system recovered 95.1% of strains from test bottles and 100% of strains from growth control bottles. Both systems performed well in the detection of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa in the presence of gentamicin. In the presence of ceftriaxone, neither system was able to recover Streptococcus pneumoniae. The ability to remove vancomycin and cefoxitin was also determined by measuring antibiotic levels remaining in bottles after 1 h of incubation. The results demonstrated remaining levels of 72 to 90% of vancomycin and 71 to 72% of cefoxitin in the BacT/Alert system. For the BACTEC system, remaining levels were 0 to 30% of vancomycin and 0% of cefoxitin. Under these simulated conditions, the BACTEC PLUS system was superior to the BacT/Alert FA system in recovering gram-positive and gram-negative bacterial pathogens in the presence of ␤-lactam antibiotics, gentamicin/penicillin, and vancomycin.

show abstract

“…Stability of the enzyme at room temperature may also be a problem. Dowling and Hirsh (1945) found that a penicillinase in veal-infusion broth showed little loss of activity over 4 weeks even at 37°C. Our present observations indicate that, in the medium used, at room temperature, the cephalosporinase activity of the P-lactamase preparation declines fairly rapidly while the penicillinase activity is relatively stable.…”

Section: Discussionmentioning

confidence: 98%

“…However, Dowling and Hirsh (1945) showed that when penicillinase was added to blood-culture medium the isolation rate of gram-positive cocci from 26 patients treated with benzyl penicillin increased. In a later study (Carleton and Ham-burger, 1963) involving only two patients treated with nafcillin for staphylococcal endocarditis, and five dogs treated with oxacillin in a staphylococcal endocarditis model, the use of 8-lactamase in blood cultures resulted in isolation of the infecting organisms; parallel cultures without P-lactamase were negative.…”

Section: Introductionmentioning

confidence: 99%

Prospective addition of -lactamase to blood culture medium

Brown

Warner²,

Taylor³

et al. 1988

Journal of Medical Microbiology

View full text Add to dashboard Cite

Summary. The value of adding P-lactamase to bottles of blood-culture medium before their distribution to wards was investigated. Significantly more bottles containing P-lactamase were culture-positive than those without (p < 0.002). In another series, when the enzyme was added to both bottles in each set there was no significant difference in isolation rates between the two bottles. The groups of organisms which were isolated more readily when P-lactamase was present were staphylococci and streptococci. Storage of P-lactamase (Genzyme broad-spectrum mixture) in bloodculture medium at room temperature resulted in rapid loss of cephalosporinase activity, whereas little decline in penicillinase activity was noted over a period of 118 days.

show abstract

The Use of Penicillinase in Cultures of Body Fluids Obtained From Patients Under Treatment With Penicillin

Cited by 13 publications

References 0 publications

Detection of bacteremia in patients receiving antimicrobial therapy: an evaluation of the antimicrobial removal device and 16B medium

Detection of bacteremia in patients receiving antimicrobial therapy: an evaluation of the antimicrobial removal device and 16B medium

Comparison of BACTEC PLUS Blood Culture Media to BacT/Alert FA Blood Culture Media for Detection of Bacterial Pathogens in Samples Containing Therapeutic Levels of Antibiotics

Prospective addition of -lactamase to blood culture medium

Contact Info

Product

Resources

About