Impact of monitoring blood volume in the BD BACTEC™ FX blood culture system: virtual volume versus actual volume

Chang, Jae Suk; Park, Jeong Su; Park, Sook-Ja; Choi, B.K.; Yoon, Nam Seop; Sung, Heungsup; Kim, Mina

doi:10.1016/j.diagmicrobio.2014.11.001

Cited by 21 publications

(21 citation statements)

References 18 publications

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“…Given the critical importance of sampling the adequate amount of blood for BC sensitivity, monitoring the volume of blood cultured is a strong quality-assurance requirement (Mermel and Maki, 1993 ; Schifman et al, 1996 ; Willems et al, 2012 ; Chang et al, 2015 ; Accoceberry et al, 2015a ). It should be surveyed through systematic program, either internal or external to the microbiology lab, and should at least include the proportions of solitary BC, and of adequately filled BC bottles (Schifman et al, 1991 , 1996 ; Mermel and Maki, 1993 ; Novis et al, 2001 ; Willems et al, 2012 ; van Ingen et al, 2013 ; Chang et al, 2015 ; Accoceberry et al, 2015a ). This latter may be estimated through either measurement of the weight of BC bottles received at the laboratories or visual inspection, although the latter is less accurate.…”

Section: Blood Culture Collectionmentioning

confidence: 99%

“…Improvement of BCs bottle filling would require enhanced training of phlebotomists, including systematic visual inspection of bottle filling at the bedside (van Ingen et al, 2013 ). In addition, some BC system manufacturers developed automated systems to estimate the level of bottle filling at the time of loading (Chang et al, 2015 ). The Bactec FX system (BD, USA), based on red blood cells metabolism, provides reliable estimates of the blood volume in BC bottles, with a mean error of 0.2 mL.…”

Section: Blood Culture Systemsmentioning

confidence: 99%

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How to Optimize the Use of Blood Cultures for the Diagnosis of Bloodstream Infections? A State-of-the Art

et al. 2016

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Bloodstream infection (BSI) is a major cause of death in developed countries and the detection of microorganisms is essential in managing patients. Despite major progress has been made to improve identification of microorganisms, blood culture (BC) remains the gold standard and the first line tool for detecting BSIs. Consensus guidelines are available to ensure optimal BSI procedures, but BC practices often deviate from the recommendations. This review provides an update on clinical and technical issues related to blood collection and to BC performance, with a special focus on the blood sample strategy to optimize the sensitivity and specificity of BCs.

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Section: Blood Culture Collectionmentioning

confidence: 99%

Section: Blood Culture Systemsmentioning

confidence: 99%

How to Optimize the Use of Blood Cultures for the Diagnosis of Bloodstream Infections? A State-of-the Art

et al. 2016

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“…It is also known that the actual blood volume collected in a BC bottle during clinical practice is difficult to estimate by ocular inspection. Hitherto published studies have shown that the amount of blood collected in BC bottles in general is lower than recommended levels (9)(10)(11). Both sampling conditions and patient characteristics are factors that can play a role in the collection of suboptimal amounts of blood.…”

mentioning

confidence: 99%

Detailed Analysis of the Characteristics of Sample Volume in Blood Culture Bottles

et al. 2019

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Blood volume is the most important variable for the detection of microorganisms in blood cultures (BCs). Most standards recommend 40 to 60 ml blood, collected in several BC bottles filled up to 10 ml. We measured blood volume in individual BC bottles and analyzed the associations of hospital, bottle type, day of the week, daily sampling time, and age and sex of the patient with sampling volume and BC result. The variation in blood volume per BC bottle was analyzed in a mixed linear model using hospital, bottle type, weekday, sampling time, age, and sex as fixed factors and patient identification (ID) and episode as random factors to control for repetitive sampling of individual patients. Only 18% of all bottles were filled with the recommended 8 to 10 ml, and 47% were filled with less than 8 ml. The mean (± standard error) volume was larger in positive bottles (9.09 ± 0.15) than in negative bottles (8.47 ± 0.07) (P < 0.001). Blood volume was larger in BacT/Alert-FA Plus bottles than in -FN Plus BC bottles (P < 0.001). There were significantly lower volumes collected during the night (P < 0.001). The volume of blood collected decreased significantly with increasing patient age (P < 0.001). Larger volumes were collected from male patients than from female patients: 8.78 (± 0.06) versus 8.36 (± 0.06) ml (mean ± standard error [SE]), respectively (P < 0.001). The odds of detecting a positive patient increases by 13% for each additional milliliter of blood drawn. Our results show that we need to work actively with the development of blood sampling routines to overcome age and sex effects and to optimize blood sampling volumes.

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“…These manual monitoring methods are labor-intensive and time-consuming. Recently, a virtual blood volume monitoring method using the BACTEC FX system, which is based on the metabolism of red blood cells, was introduced, and it demonstrated a linear correlation with manual blood volume measurements [7]. The BACTEC FX system provides reliable estimates of the blood volume in blood culture bottles, with a mean error of 0.2 mL.…”

Section: Resultsmentioning

confidence: 99%

“…All positive cultures were identified using the VITEK2 microbial ID/AST testing system (bioMérieux, Inc., Hazelwood, MO, USA). To monitor blood volume, we used the BACTEC FX blood system, which analyzed samples in batches of 25 Aerobic/F media bottles [7]. The culture processing and identification of microorganism were conducted identically between pre-and post-intervention periods.…”

Section: Methodsmentioning

confidence: 99%

Effects of Blood Volume Monitoring on the Rate of Positive Blood Cultures from the Emergency Room

Chung

Kim

et al. 2016

Ann Clin Microbiol

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Background: Blood cultures are essential in diagnosing and treating sepsis. There are several factors that affect the diagnostic yield of blood cultures such as the number of blood sampling episodes, the incubation period, the type and volume of culture media, and the amount of blood drawn. This study aimed to elucidate whether monitoring the volume of blood drawn with an educational intervention could affect the diagnostic quality of blood cultures. Methods: We implemented quality monitoring for the blood volume drawn during blood culture testing for adults in an emergency room. We instructed the nurses in the emergency room to draw the optimal amount of blood and to reduce the number of blood culture sets from three to two. We analyzed and compared the amount of blood drawn, the rate of positive blood cultures, the contamination rate, and time to positivity (TTP) between 908 patients pre-intervention and 921 patients post-intervention. Results: The amount of blood drawn increased from 0.7±0.3 mL per bottle (pre-intervention) to 6.5±1.7 mL per bottle (post-intervention) (P＜0.0001). The rate of positive blood culture post-intervention (12.14%) was higher than that pre-intervention (6.65%) (P＜0.0001). The contamination rate post-intervention (1.82%) was also significantly greater than that pre-intervention (0.60%) (P＜0.0001). Except for anaerobes, there was no significant difference in the distribution of microorganisms between the pre-and post-intervention periods. The TTP for anaerobe bottles post-intervention was significantly shorter than that of pre-intervention (

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Impact of monitoring blood volume in the BD BACTEC™ FX blood culture system: virtual volume versus actual volume

Cited by 21 publications

References 18 publications

How to Optimize the Use of Blood Cultures for the Diagnosis of Bloodstream Infections? A State-of-the Art

How to Optimize the Use of Blood Cultures for the Diagnosis of Bloodstream Infections? A State-of-the Art

Detailed Analysis of the Characteristics of Sample Volume in Blood Culture Bottles

Effects of Blood Volume Monitoring on the Rate of Positive Blood Cultures from the Emergency Room

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