This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wilson, M L Articles by Reller, L B Search for Related Content PubMed PubMed Citation Articles by Wilson, M L Articles by Reller, L B

Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus 26 aerobic blood culture bottle, and 10-milliliter isolator blood culture system for detection of fungemia and bacteremia.

Clinical Microbiology Laboratory, Duke University Medical Center, Durham, North Carolina 27710.

ABSTRACT

The BACTEC high-blood-volume fungal medium (HBV-FM) (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md.) was compared with the Isolator (IS) tube and the BACTEC Plus 26 (BP26) blood culture bottle for the ability to recover fungi from the blood of adult patients suspected of having fungemia. A total of 6,836 blood culture sets that fulfilled criteria for inclusion in the study were received. Three separate comparisons were performed: 4,907 HBV-FM versus IS, 4,886 BP26 versus HBV-FM, and 4,949 BP26 versus IS. For the HBV-FM versus IS comparison, 218 isolates were recovered: 125 (57.3%) were bacteria and 93 (42.7%) were fungi. HBV-FM was comparable to IS for recovery of yeasts, but IS was superior for recovery of Histoplasma capsulatum (25 versus 0 isolates recovered [P < 0.001]). Growth of Torulopsis glabrata was detected earlier (P < 0.05) in HBV-FM bottles. For the BP26 versus HBV-FM comparison, 229 isolates were recovered: 161 (70.3%) were bacteria, and 68 (29.7%) were fungi. HBV-FM was superior for recovery of T. glabrata (P < 0.025) and all fungi combined (P < 0.025). There were no statistically significant differences in the speed of detection of microbial growth. For the BP26 versus IS comparison, 251 isolates were recovered: 165 (65.7%) were bacteria, and 86 (34.2%) were fungi. IS was superior for recovery of H. capsulatum (P < 0.001), T. glabrata (P < 0.05), and fungi other than H. capsulatum (P < 0.025). BP26 was superior for recovery of all bacteria combined (P < 0.001) and viridans group streptococci (P < 0.01). Growth of T. glabrata (P < 0.05) was detected earlier in IS tubes. Growth of Staphylococcus aureus (P < 0.01), viridans group streptococci (P < 0.01), Pseudomonas aeruginosa (P < 0.05), and all microorganisms combined (P < 0.05) was detected earlier in BP26 bottles. For yeast, 57 of 59 (96.6%), 79 of 80 (98.7%), and 64 of 67(95.5%) were recovered from BP26 bottles, HBV-FM bottles, and IS tubes, respectively, by day 14; for H. capsulatum, 14 of 36 (38%) isolates were recovered from IS tubes by day 14. Mean times of recovery were similar for BACTEC bottles and IS. We conclude that (i) for recovery of fungi from blood cultures, HBV-FM is equivalent to IS (with the exception of H. capsulatum); (ii) for recovery of bacteria, BP26 is superior to IS; (iii) BP26 bottles are inferior to both HBV-FM bottles and IS tubes for recovery of T. glabrata; and (iv) HBV-FM bottles must be paired with another blood culture bottle or system to optimize detection of bacteremia.

This article has been cited by other articles:

• Kauffman, C. A. (2007). Histoplasmosis: a Clinical and Laboratory Update. Clin. Microbiol. Rev. 20: 115-132 [Abstract] [Full Text]  
• Golan, Y., Wolf, M. P., Pauker, S. G., Wong, J. B., Hadley, S. (2005). Empirical Anti-Candida Therapy among Selected Patients in the Intensive Care Unit: A Cost-Effectiveness Analysis. ANN INTERN MED 143: 857-869 [Abstract] [Full Text]  
• EL-MAHALLAWY, H.A., ATTIA, I., ALI-EL-DIN, N.H., SALEM, A.E., ABO-EL-NAGA, S. (2002). A prospective study on fungal infection in children with cancer. J Med Microbiol 51: 601-673 [Abstract] [Full Text]  
• Fuller, D. D., Davis, T. E. Jr., Denys, G. A., York, M. K. (2001). Evaluation of BACTEC MYCO/F Lytic Medium for Recovery of Mycobacteria, Fungi, and Bacteria from Blood. J. Clin. Microbiol. 39: 2933-2936 [Abstract] [Full Text]  
• McDonald, L. C., Weinstein, M. P., Fune, J., Mirrett, S., Reimer, L. G., Reller, L. B. (2001). Controlled Comparison of BacT/ALERT FAN Aerobic Medium and BACTEC Fungal Blood Culture Medium for Detection of Fungemia. J. Clin. Microbiol. 39: 622-624 [Abstract] [Full Text]  
• Procop, G. W., Cockerill, F. R. III, Vetter, E. A., Harmsen, W. S., Hughes, J. G., Roberts, G. D. (2000). Performance of Five Agar Media for Recovery of Fungi from Isolator Blood Cultures. J. Clin. Microbiol. 38: 3827-3829 [Abstract] [Full Text]  
• Waite, R. T., Woods, G. L. (1998). Evaluation of BACTEC MYCO/F Lytic Medium for Recovery of Mycobacteria and Fungi from Blood. J. Clin. Microbiol. 36: 1176-1179 [Abstract] [Full Text]  
• Ziegler, R., Johnscher, I., Martus, P., Lenhardt, D., Just, H.-M. (1998). Controlled Clinical Laboratory Comparison of Two Supplemented Aerobic and Anaerobic Media Used in Automated Blood Culture Systems To Detect Bloodstream Infections. J. Clin. Microbiol. 36: 657-661 [Abstract] [Full Text]