The positivity rate and time to recovery of pathogens were compared in Roche Septi-Chek (RSC-TSB) and BACTEC radiometric systems on 3,539 paired blood cultures. Both systems were steadily agitated, with frequent subculturing or processing of the RSC-TSB agar slides and BACTEC bottles, respectively, during the first 24 h of incubation. The RSC-TSB system recovered 249 pathogens (7.0% positivity rate), compared with 234 (6.6% positivity rate) isolates recovered from BACTEC. For the most common isolates, Staphylococcus aureus and the Enterobacteriaceae, the median time to detection was 15.8 h for BACTEC and 18.6 h for the RSC-TSB system. No statistically significant difference was observed in recovery of organisms from the two systems, except for S. aureus (P < 0.05). In the RSC-TSB system, 42% of S. aureus, 58% of the Enterobacteriaceae, and 45% of Pseudomonas aeruginosa isolates had sufficient growth on the agar slant to allow performance of rapid standardized identification and susceptibility studies. In comparison with other studies using static incubation, it appears that agitation and frequent subculturing of the RSC-TSB system during the first 24 h of incubation decreased the time to detection for the majority of significant blood culture isolates.

Identification and susceptibility studies were performed on 301 blood and urine Streptococcusfaecalis and Streptococcus faecium isolates. Strep Trio-Tubes S4, S5, and S3 (Carr-Scarborough Microbiologicals, Inc.) were compared with conventional methods for accuracy and rapidity. Of 282 isolates identified as S. faecalis, 98% were identified by species in 4 h with Trio-Tubes; the same percentage of isolates analyzed by conventional methods were identified in 24 h. Ali 14 S. faecium isolates (approximately 5% of the total number of isolates) were identified by Trio-Tubes in 24 h. In vitro MIC susceptibility testing of the isolates was performed by the Dynatech 2000 microdilution technique (Dynatech Laboratories, Inc.). Several newly developed antimicrobial agents, including imipenem (a carbapenem) and some of the quinolone drugs, i.e., CI-934, ciprofioxacin, A-56619, A-56620, amifloxacin, norfloxacin, and enoxacin, were tested, as were ampicillin, erythromycin, and vancomycin. Both ampicillin and vancomycin showed good activity against S. faecalis, with MICs for 90% of isolates tested (MIC%0s) of 1 and 2 ,ug/ml, respectively; with S. faecium, ampicillin exhibited an MIC90 of 16 ,ug/ml and vancomycin exhibited an MIC9. of 2 ,ug/mI. Of the newer antimicrobial agents, imipenem and CI-934 exhibited the greatest activity against S. faecalis strains, with MICg9s of 2 and 0.5 ,ug/ml, respectively. MBCs against the isolates were determined with CI-934, with 90% of S. faecalis strains showing MBCs of 1 ,ug/ml or less.