Clinical laboratory comparison of the 10-ml isolator blood culture system with BACTEC radiometric blood culture media

Kellogg, James A.; Manzella, John P.; McConville, John H.

doi:10.1128/jcm.20.4.618-623.1984

Cited by 53 publications

(23 citation statements)

References 16 publications

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“…Most studies report between 1 and 100 CFU/mL (20). However, some have documented concentrations of < 1 CFU/mL (21)(22)(23) and some > 100 CFU/mL (24,25). Although the present assay has good sensitivity, it is not adequate to detect most bacteremias.…”

Section: Discussionmentioning

confidence: 75%

Sandwich immunoassay for the detection of lipoteichoic acid

Tadler

Tice

Wos

1989

Clinical Laboratory Analysis

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A sandwich immunoassay has been developed for the detection of lipoteichoic acid (LTA), a major cell wall constituent of gram-positive bacteria, from whole blood and ISOLATOR supernate. Monoclonal antibodies were produced to purified LTA from Streptococcus mutans, BHT and were further characterized for crossreactivity with gram-positive and negative bacteria and for reactivity to substituted and unsubstituted LTA. Eight monoclonal antibodies were identified that reacted exclusively with gram-positive bacteria. Those antibodies able to capture 3H-LTA were chosen to develop a sandwich immunoassay. The assay has a sensitivity of 0.2 ng LTA/mL in PBS, 0.5 ng/mL in whole blood and 2.0 ng/mL in whole blood that has been processed through the ISOLATOR. Further development of this assay may lead to the rapid detection of LTA from body fluids.

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Section: Discussionmentioning

confidence: 75%

Sandwich immunoassay for the detection of lipoteichoic acid

Tadler

Tice

Wos

1989

Clinical Laboratory Analysis

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“…du Pont de Nemours & Co., Inc., Wilmington, Del.) technique has been studied extensively (1,3,4,9,11,12,(16)(17)(18)(19)29), and several authors report that LC may be advantageous for detecting organisms in the presence of antibiotics (12,16,23,29). The LC technique, however, requires centrifugation and manipulation, which cannot always be promptly performed in laboratories with limited staffing.…”

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confidence: 99%

Effect of delay in processing on lysis-centrifugation blood culture results from marrow transplant patients

et al. 1989

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The effect of delay in processing on results of lysis-centrifugation (LC; Isolator) blood cultures was assessed in 4,577 paired blood specimens. Blood specimens were obtained at all hours from 384 febrile marrow transplant patients with indwelling venous catheters and were processed by the LC technique and by a conventional two-bottle method. Most patients (84%) were receiving broad-spectrum antibiotics at the time of blood culture. Specimens were delivered to the laboratory, where Isolator tubes were held at 35°C and processed in batches between 0700 and 1730 h daily. This procedure resulted in a delay beyond the manufacturer-suggested processing time of less than 8 h for 1,853 (42%) of the LC cultures. There was no overall difference in the recovery of organisms present in LC cultures processed after being held for 8 to 24 h compared with the conventional two-bottle method. LC methodology had shorter time to detection than the conventional method for detection of Candida spp. and Pseudomonas spp. (P < 0.05). However, time to detection for Streptococcus spp. and members of the family Enterobacteriaceae, responsible for 16.3% of total isolates, was prolonged significantly by delay in processing when compared with the conventional two-bottle method (P < 0.01). Results of this study support the recommendation of the manufacturer for processing of Isolator tubes within 8 h or less. Although one can safely delay processing beyond 8 h in terms of total recovery of organisms, such delays were associated with longer time to detection for certain important potentially pathogenic organisms which accounted for a sizeable proportion of blood culture isolates from marrow transplant patients.

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“…While most studies on the Isolator (E. I. du Pont de Nemours & Co., Inc., Wilmington, Del.) report that it enables the recovery of significantly more bacteria and fungi from the blood than do conventional bottle systems, the lysis-centrifugation device nevertheless failed to detect from 9 to 29% of the pathogens in these studies (1, 2, 4-6, [8][9][10][11][12]. One of the assets of the Isolator is the frequency with which it detects very small numbers of pathogens which may be missed by bottle systems.…”

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confidence: 99%

“…One of the assets of the Isolator is the frequency with which it detects very small numbers of pathogens which may be missed by bottle systems. In one study (9), 50% of the pathogens recovered by the Isolator yielded a total of 10 colonies or less from 10 ml of blood; 18% were recovered as a single colony. Kiehn et al (11) similarly reported that 52% of their positive Isolator cultures contained less than 1 CFU/ml of blood.…”

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confidence: 99%

“…False-negative Isolator cultures, therefore, appear less related to antibiotic pretreatment than to low numbers of organisms in the blood, volume of blood sampled, and possibly the extensive manipulations necessary in processing the Isolator. No blood culture system alone, including the Isolator, appears to be sufficiently sensitive for the recovery of bacteria and yeasts (5,6,(8)(9)(10)(11). Because of the combined labor and material expenses associated with the routine use of both the Isolator and an additional bottle system, it would obviously be more cost-effective if the recovery rate of the Isolator could be improved enough to use the device as a single blood culture system.…”

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confidence: 99%

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Distribution of bacteria and yeasts within the 10-ml Isolator during the processing of seeded blood samples

Kellogg¹,

Levisky²

1986

J Clin Microbiol

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Forty-five organisms consisting of stock cultures and clinical isolates of bacteria and yeasts were separately inoculated into outdated blood bank blood to achieve a concentration of approximately 100 CFU/ml. Blood with each organism was introduced into groups of four Isolators (E. I. du Pont de Nemours & Co., Inc., Wilmington, Del.), which were then processed according to the Isostat instructions of the manufacturer. The supernatant, sediment, and wash (material removed from the surface of the slanted stopper after sediment removal) were inoculated onto 5% sheep blood agar plates. Cultures were incubated aerobically (5 to 10% C02) at 35°C for 48 to 72 h. From the 180 Isolators, the mean recovery was 6% (range, 0 to 48%) for the supernatant, 87% (range, 47 to 98%) for the sediment, and 8% (range, 3 to 23%) for the wash. Neither variation among technologists nor intentional misalignment of additional Isolators in the centrifuge could explain all of the losses of microorganisms from the sediment. The manual nature of the Isolator procedure, which led to the loss of significant amounts of organisms from the sediment, may help to explain false-negative Isolator results obtained from blood of patients, particularly when small numbers of pathogens are present.

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Clinical laboratory comparison of the 10-ml isolator blood culture system with BACTEC radiometric blood culture media

Cited by 53 publications

References 16 publications

Sandwich immunoassay for the detection of lipoteichoic acid

Sandwich immunoassay for the detection of lipoteichoic acid

Effect of delay in processing on lysis-centrifugation blood culture results from marrow transplant patients

Distribution of bacteria and yeasts within the 10-ml Isolator during the processing of seeded blood samples

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