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Journal of Clinical Microbiology, August 2000, p. 2994-2997, Vol. 38, No. 8
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 (
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


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