Efficient Inactivation of Clinically Relevant Antimicrobial Drug Concentrations by BacT/Alert or Bactec Resin-Containing Media in Simulated Adult Blood Cultures

Menchinelli, Giulia; Liotti, Flora Marzia; Giordano, Liliana; Angelis, Giulia De; Sanguinetti, Maurizio; Spanu, Teresa

doi:10.1128/aac.00420-19

Cited by 10 publications

(23 citation statements)

References 19 publications

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“…Interestingly, Menchinelli and colleagues recently reported P. aeruginosa recovery at all tested concentrations of meropenem, which were higher than the ones used here, whereas this study only had trough bottles alarm positive (19). This difference in observations may be attributed to the higher target used for the starting inoculums (50 to 100 CFU per 0.5 ml versus 7 to 30 CFU per 0.5 ml) (19). While the above conclusions are well supported for P. aeruginosa, the results against E. coli and K. pneumoniae were not as clear.…”

Section: Discussioncontrasting

confidence: 79%

“…the conclusions of Grupper and colleagues (10) in that collection of blood cultures right before the scheduled dose, when antibiotic concentrations are predicted to be the lowest, should be a best practice for obtaining blood cultures for patients already receiving antibiotics. Interestingly, Menchinelli and colleagues recently reported P. aeruginosa recovery at all tested concentrations of meropenem, which were higher than the ones used here, whereas this study only had trough bottles alarm positive (19). This difference in observations may be attributed to the higher target used for the starting inoculums (50 to 100 CFU per 0.5 ml versus 7 to 30 CFU per 0.5 ml) (19).…”

Section: Discussioncontrasting

confidence: 70%

“…Again, Menchinelli and colleagues observed better recovery rates among their levofloxacin bottles. In addition to the higher inoculum, the lower levofloxacin peak concentration used in their study may have contributed to these differences (19). The following differences between manufacturers were observed: BacT/Alert bottles alarmed positive for E. coli paired with midpoint and trough concentrations of imipenem and for the midpoint concentration of levofloxacin, while the corresponding Bactec bottles remained negative.…”

Section: Discussionmentioning

confidence: 92%

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Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

2019

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Blood culture bottles containing antibiotic binding resins are routinely used to minimize artificial sterilization in the presence of antibiotics. However, the resin binding kinetics can differ between antibiotics and concentrations. This study assessed the impact of clinically meaningful peak, midpoint, and trough concentrations of meropenem, imipenem, cefepime, cefazolin, levofloxacin, and piperacillin-tazobactam on the recovery of Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae from resin-containing BacT/Alert FA Plus and Bactec Aerobic/F blood culture bottles. P. aeruginosa-inoculated bottles alarmed positive in 4/20 (20%), 16/20 (80%), and 20/20 (100%) of those with peak, midpoint, and trough concentrations of antipseudomonal agents, respectively (P ≤ 0.001). E. coli was recovered from 8/24 (33%), 11/24 (46%), and 14/24 (58%) of bottles with peak, midpoint, and trough concentrations, respectively (P = 0.221). K. pneumoniae was recovered from 8/16 (50%) at all concentrations of the studied antibiotics (P = 1.0). BacT/Alert and Bactec bottles inoculated with antibiotics and P. aeruginosa had similar times to detection (TTD) (P = 0.352); however, antibiotic-containing BacT/Alert bottles had a shorter TTD compared with antibiotic-containing Bactec bottles for E. coli (P = 0.026) and K. pneumoniae (P ≤ 0.001). Pathogen recovery in BacT/Alert FA Plus and Bactec Aerobic/F blood culture bottles containing antibiotic binding resins was greatly reduced in the presence of antibiotics, especially at higher concentrations. These data support the practice of drawing blood cultures immediately before an antibiotic dose to maximize the chances of pathogen recovery.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 92%

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Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

2019

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“…These data suggest that the greatest likelihood of recovery overall will be in the presence of trough concentrations. Our observations are largely similar to past studies, with a few notable exceptions (9,(11)(12)(13)23). In a recent study, Menchinelli and colleagues observed sterilization of all E. coli-inoculated anaerobic bottles exposed to meropenem (23), whereas we detected recovery at the midpoint and trough concentrations in the BacT/Alert bottles.…”

Section: Discussionsupporting

confidence: 91%

Effect of Clinically Meaningful Antibiotic Concentrations on Recovery of Escherichia coli and Klebsiella pneumoniae Isolates from Anaerobic Blood Culture Bottles with and without Antibiotic Binding Resins

2019

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Blood cultures are routinely collected in pairs of aerobic and anaerobic bottles. Artificial sterilization of Gram-negative bacteria in aerobic bottles containing clinically meaningful antibiotic concentrations has previously been observed. This study assessed recovery from anaerobic bottles with and without antibiotic binding resins. We studied the recovery of Escherichia coli and Klebsiella pneumoniae when exposed to meropenem, imipenem, cefepime, cefazolin, levofloxacin, and piperacillin-tazobactam in resin-containing BacT/Alert FN Plus and BD Bactec Plus anaerobic/F bottles as well as resin-free BacT/Alert SN and BD Bactec standard anaerobic bottles. Bottles were inoculated with bacteria and whole blood containing peak, midpoint, or trough concentrations and incubated for up to 120 hours in their respective detection systems. In E. coli resin-containing bottles, recovery was observed in 10/24 (42%), 17/24 (71%), and 18/24 (75%) (P = 0.034) of those exposed to peak, midpoint, and trough concentrations, respectively. In K. pneumoniae resin-containing bottles, recovery was observed in 8/16 (50%), 10/16 (63%), and 10/16 (63%) (P = 0.710), respectively. No growth was detected in bottles containing cefepime regardless of concentration, while recovery was observed in the presence of all concentrations of cefazolin and piperacillin-tazobactam. Recovery in bottles with meropenem and imipenem was more frequently observed in BacT/Alert FN Plus bottles compared with Bactec Plus bottles. Resin-free bottles demonstrated significantly lower recovery than bottles containing binding resin. Clinical concentrations of certain antibiotics can adversely affect detection of E. coli and K. pneumoniae in anaerobic blood culture bottles. Obtaining blood cultures immediately before a dose and utilizing resin-containing anaerobic bottles will maximize the likelihood of recovery.

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“…Until now, several blood culture simulation studies (involving blood culture bottles injected with whole blood, antimicrobial agents, and microorganisms) have compared the antimicrobial inactivation efficiency of BacT/ALERT FAN Plus media and BACTEC Plus media, including in both anaerobic and aerobic blood culture bottles. 6 , 7 However, since the BacT/ALERT FAN Plus media was only recently approved in the Chinese mainland, data on the performance of antimicrobial agent inactivation of BacT/ALERT FAN Plus media from China mainland is not yet available.…”

Section: Introductionmentioning

confidence: 99%

Inactivation of Clinically Frequently Used Antimicrobial Agents By BacT/ALERT FAN Plus and BACTEC Aerobic and Anaerobic Culture Media in Simulated Blood Cultures: First Comparative Evaluation in China Mainland

Xu¹,

Wei²,

Zhu³

et al. 2021

IDR

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Purpose: To evaluate the antimicrobial inactivation capabilities of BacT/ALERT (FA Plus and FN Plus) and BACTEC (Plus Aerobic/F and Lytic/10 Anaerobic/F) media. Patients and Methods: The inactivation capabilities of the commercial blood culture media were compared using 21 microorganism-antimicrobial combinations in simulated adult blood cultures. Results: BacT/ALERT culture media demonstrated higher detection rates than the BACTEC culture media. The recovery rates of the aerobic bottles were 74/115 (64.3%) for FA Plus bottles and 64/115 (55.7%) for BACTEC Aerobic Plus bottles. The BacT/ALERT FAN Plus culture media exhibited a shorter time to detection (TTD). The TTD of FA Plus media was 14.7 h, 4.85 h shorter than the BACTEC Aerobic media (19.55 h), while the TTDs of FN Plus media and BACTEC Anaerobic media were 16.8 h and 18.4 h, respectively. Conclusion: BacT/ALERT (FA Plus and FN Plus) media showed relative, but not absolute, advantages, as it had higher detection rates and shorter TTD and thus can be selectively applied to patients with prior use of antimicrobial agents before blood culture samples are taken.

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Efficient Inactivation of Clinically Relevant Antimicrobial Drug Concentrations by BacT/Alert or Bactec Resin-Containing Media in Simulated Adult Blood Cultures

Cited by 10 publications

References 19 publications

Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations

Effect of Clinically Meaningful Antibiotic Concentrations on Recovery of Escherichia coli and Klebsiella pneumoniae Isolates from Anaerobic Blood Culture Bottles with and without Antibiotic Binding Resins

Inactivation of Clinically Frequently Used Antimicrobial Agents By BacT/ALERT FAN Plus and BACTEC Aerobic and Anaerobic Culture Media in Simulated Blood Cultures: First Comparative Evaluation in China Mainland

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