Comparative Study of Three Different BACTEC Culture Media for the Detection of Bacteremia in Ambulatory and Hospitalized Children

Abstract

To compare the yield of two aerobic and an anaerobic BACTEC blood culture media in detecting bacteremia in ambulatory and hospitalized care settings at a children's hospital, a prospective cohort study was completed. Over an 18-month period, equal blood volumes (minimum of 1 mL/bottle) were inoculated into a three-bottle culture set including aerobic BACTEC NR 6A, aerobic BACTEC PEDS Plus and anaerobic NR 7A broths. Chart reviews were completed on all children with bacteremia to determine whether the isolate was clinically significant based on predefined criteria. Among 5328 evaluable blood culture sets, 323 clinically significant organisms (110 from ambulatory and 213 from hospitalized children) were isolated. Most Streptococcus pneumoniae, Haemophilus species, and Neisseria or Moraxella species were recovered from children attending the emergency department or out-patient clinics. Important isolates in hospitalized children included most of the staphylococci and Enterobacteriaceae, and all group D enterococci, Gram-negative nonfermentative bacilli and all Candida species. Overall, significantly more isolates were detected only in the anaerobic bottle from ambulatory children (P<0.0001), including 13 of 54 (24%) patients with S pneumoniae bacteremias presenting to the emergency department. This study indicated that different BACTEC blood culture media combinations are needed in ambulatory and hospitalized pediatric care settings to ensure the optimal recovery of all types of isolates. Whereas aerobic blood culture bottles are adequate for detection of bacteremia in hospitalized children, the common occurrence of fastidious organisms mandates the need for a combined aerobic/anaerobic culture set in ambulatory pediatric care settings.

Diagnostic value of pediatric blood culture bottles for acute postoperative endophthalmitis

“…They require immediate incubation (not available at all ophthalmologic centers), and endophthalmitis positivity varies widely in the literature, ranging from 24 to 72% (3,6–8,10–17). These low sensitivities can be explained by various factors such as the small volume of specimens, the use of antibiotics before the collection of clinical material and the presence of fastidious microorganisms causing endophthalmitis (18).…”

Diagnóstico etiológico das endoftalmites e análise direta do humor vítreo em frasco de hemocultura por espectrometria de massas MALDI-TOF

“…Foram incluídas 20 amostras analisadas na cultura convencional, no período entre 2010 e 2011, com positividade de 35%, e 34 amostras analisadas com frasco de hemocultura infantil, no período entre 2012 e 2015, com melhora da positividade para 64,7% (14) . O frasco de hemocultura infantil foi desenvolvido para amostras com volumes menores de até 3 mililitros (mL), resultando em maior positividade em relação ao frasco de hemocultura de adulto (volume até 10 mL) (78) . Desta forma, estes frascos foram usados no presente estudo cujas amostras oculares são de pequeno volume (8,91) .…”