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Journal of Clinical Microbiology, August 2000, p. 2994-2997, Vol. 38, No. 8
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Comparison of BACTEC MYCO/F LYTIC and WAMPOLE ISOLATOR 10 (Lysis-Centrifugation) Systems for Detection of Bacteremia, Mycobacteremia, and Fungemia in a Developing Country

Lennox K. Archibald,1,* L. Clifford McDonald,1,dagger Rachel M. Addison,2 Celeste McKnight,2 Terry Byrne,2 Hamish Dobbie,3,Dagger Okey Nwanyanwu,3,§ Peter Kazembe,3 L. Barth Reller,2 and William R. Jarvis1

Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia,1 Duke University Medical Center, Durham, North Carolina,2 and Lilongwe Central Hospital, Lilongwe, Malawi3

Received 11 January 2000/Returned for modification 16 February 2000/Accepted 30 May 2000

In less-developed countries, studies of bloodstream infections (BSI) have been hindered because of the difficulty and costs of culturing blood for bacteria, mycobacteria, and fungi. During two study periods (study period I [1997] and study period II [1998]), we cultured blood from patients in Malawi by using the BACTEC MYCO/F LYTIC (MFL), ISOLATOR 10 (Isolator), Septi-Chek AFB (SC-AFB), and Septi-Chek bacterial (SC-B) systems. During study period I, blood was inoculated at 5 ml into an MFL bottle, 10 ml into an Isolator tube for lysis and centrifugation, and 10 ml into an SC-B bottle. Next, 0.5-ml aliquots of Isolator concentrate were inoculated into an SC-AFB bottle and onto Middlebrook 7H11 agar slants, chocolate agar slants, and Inhibitory Mold Agar (IMA) slants. During study period II, the SC-B and chocolate agar cultures were discontinued. MFL growth was detected by fluorescence caused by shining UV light (lambda  = 365 nm) onto the indicator on the bottom of the bottle. During study period I, 251 blood cultures yielded 44 bacterial isolates. For bacteremia, the MFL was similar to the Isolator concentrate on chocolate agar (34 of 44 versus 27 of 44; P, not significant [NS]), but more sensitive than the SC-B bottle (34 of 44 versus 24 of 44; P = 0.05). For both study periods combined, 486 blood cultures yielded 37 mycobacterial and 13 fungal isolates. For mycobacteremia, the sensitivities of the MFL and Isolator concentrate in the SC-AFB bottle were similar (30 of 37 versus 29 of 37; P, NS); the MFL bottle was more sensitive than the concentrate on Middlebrook agar (30 of 37 versus 15 of 37; P = 0.002). For fungemia, the MFL bottle was as sensitive as the SC-B bottle or Isolator concentrate on chocolate agar or IMA slants. We conclude that the MFL bottle, inoculated with just 5 ml of blood and examined under UV light, provides a sensitive and uncomplicated method for comprehensive detection of BSI in less-developed countries.


* Corresponding author. Mailing address: Hospital Infections Program, Centers for Disease Control and Prevention, Mailstop E-69, 1600 Clifton Rd., Atlanta, GA 30333. Phone: (404) 639-6443. Fax: (404) 639-6459. E-mail: LCA6{at}CDC.GOV.

dagger Present address: Division of Clinical Research, National Health Research Institutes, Taipei 11529, Taiwan.

Dagger Present address: Department of Renal Medicine, The Middlesex Hospital, London W1N 8AA, United Kingdom.

§ Present address: Office of Health, Population & Nutrition, USAID/Mozambique, Maputo, Mozambique.


Journal of Clinical Microbiology, August 2000, p. 2994-2997, Vol. 38, No. 8
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.



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