Impact of the BACTEC NR system in detecting Candida fungemia

Muñoz, Paola; Quirós, Juan Carlos López Bernaldo de; Berenguer, Juan; Créixems, Marta Rodríguez; Picazo, Juan J.; Bouza, Emilio

doi:10.1128/jcm.28.3.639-641.1990

Cited by 14 publications

(7 citation statements)

References 22 publications

(31 reference statements)

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“…In general, the mean times for recovery of yeasts from IS tubes and BP26 bottles were consistent with those previously published (3,4,9,19,21,23,29). The differences in mean recovery times generally were small and thus probably were not clinically important.…”

Section: Discussionsupporting

confidence: 89%

“…Finally, the IS tube, like the HBV-FM bottle, accepts inocula of up to 10 ml of blood. The BP26 bottle, which previously has been shown to be an acceptable method for recovering common yeasts and bacteria (16,19,30), was included in the evaluation to (i) ensure that each patient in the study had an adequate blood culture for bacterial pathogens and (ii) assess the ability of the BP26 bottle to recover fungi in a timely manner. In addition, the BP26 bottle, like the HBV-FM bottle and IS tube, accepts inocula of up to 10 ml of blood.…”

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confidence: 99%

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Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus 26 aerobic blood culture bottle, and 10-milliliter isolator blood culture system for detection of fungemia and bacteremia

et al. 1993

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The BACTEC high-blood-volume fungal medium (HBV-FM) (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md.) was compared with the Isolator (IS) tube and the BACTEC Plus 26 (BP26) blood culture bottle for the ability to recover fungi from the blood of adult patients suspected of having fungemia. A total of 6,836 blood culture sets that fulfilled criteria for inclusion in the study were received. Three separate comparisons were performed: 4,907 HBV-FM versus IS, 4,886 BP26 versus HBV-FM, and 4,949 BP26 versus IS. For the HBV-FM versus IS comparison, 218 isolates were recovered: 125 (57.3%) were bacteria and 93 (42.7%) were fungi. HBV-FM was comparable to IS for recovery of yeasts, but IS was superior for recovery of Histoplasma capsulatum (25 versus 0 isolates recovered [P < 0.001]). Growth of Torulopsis glabrata was detected earlier (P < 0.05) in HBV-FM bottles. For the BP26 versus HBV-FM comparison, 229 isolates were recovered: 161 (70.3%) were bacteria, and 68 (29.7%) were fungi. HBV-FM was superior for recovery of T. glabrata (P < 0.025) and all fungi combined (P < 0.025). There were no statistically significant differences in the speed of detection of microbial growth. For the BP26 versus IS comparison, 251 isolates were recovered: 165 (65.7%) were bacteria, and 86 (34.2%) were fungi. IS was superior for recovery of H. capsulatum (P < 0.001), T. glabrata (P < 0.05), and fungi other than H. capsulatum (P < 0.025).

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus 26 aerobic blood culture bottle, and 10-milliliter isolator blood culture system for detection of fungemia and bacteremia

et al. 1993

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Section: Discussionsupporting

confidence: 90%

BACTEC high-blood-volume fungal medium versus Isolator comparison misleading

Hunter¹

1993

J Clin Microbiol

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BACTEC High-Blood-Volume Fungal Medium versus Isolator Comparison Misleading Scientific investigation must be evaluated by using actual experimental conditions. Wilson et al. (4) mislead the reader by their global conclusion that BACTEC high-blood-volume fungal medium (HBV-FM) is equivalent and Bactec Plus 26 (BP26) is superior to Isolator. Tenets of microbial nutrition and experimental design were not followed, yet conclusions were drawn from flawed testing. Concerning microbial nutrition, the media and incubation conditions used for Isolator are not entirely those suggested by the manufacturer, and, as such, they create additional variables for simultaneous evaluation of both fungal and bacterial recovery. Regarding temperature, two of the four plates (Isolator) were incubated at 25°C (not optimal for growth of streptococci), whereas all BACTEC media were at 35°C. Regarding media, Why was Sabouraud dextrose agar selected rather than SABHI or BHI (suggested by manufacturer), both of which more closely resemble the formulation of BACTEC FM? Sabouraud (one plate) is neither conducive for bacterial growth nor recommended for recovery of fungi from clinical specimens such as blood (3). Although an option, Sabouraud was devised for dermatophytes (1). The type of Sabouraud (4% dextrose, pH 5.6) or Emmons medium (2% dextrose, pH neutral) used was not indicated. Media selected for recovery of fungi can influence yield (2), and one could postulate quite different results had optimal media been used. Dating back at least to the early 1940s, the literature is replete with examples of interrelationships between temperature, pH, nutritional requirements, and microbial growth. Such blatant omissions and inequalities by design are difficult to understand. Concerning the experimental design, basic principles of investigation, and especially those for blood cultures, dictate Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus 26 aerobic blood culture bottle, and 10-milliliter Isolator blood culture system for detection of fungemia and bacteremia. J. Clin. Microbiol. 31:865-871.

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“…However, laboratories located in areas of endemicity for dimorphic fungi or those whose patient populations include patients with systemic infections should establish their own protocol for isolating dimorphic, filamentous or slowly growing fungi from blood cultures. Table 2 shows a comparison of detection times (in days) for the BACTEC NR 660 and the BACTEC radiometric 460 systems with agitation for 144 h versus 24 h and also for the lysis-centrifugation system (Dupont isolator) (2,(8)(9)(10)13). In both of our studies utilizing 144 h of agitation, our detection times for the recovery of yeasts are, for most yeasts, less than those reported for the same systems with agitation for only 24 h. We conclude that extended agitation is a valuable addition to the BACTEC NR 660 protocol, and the simple installation of orbital agitation equipment in incubators provides the system with an effective enhancement for yeasts.…”

Section: Discussionmentioning

confidence: 99%

Value of extended agitation and subculture of BACTEC NR 660 aerobic resin blood culture bottles for clinical yeast isolates

Prevost-Smith

Hutton

1992

J Clin Microbiol

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From 10,351 blood cultures, we prospectively studied 1,000 BACTEC NR 660 aerobic resin blood culture bottles (26+ and Peds Plus) for patients suspected of having yeast septicemia to determine whether extended agitation and subculturing would increase the recovery ofyeasts. Aerobic bottles were agitated continuously for 144 h. On day 7, 1,000 culture-negative aerobic bottles which had fungal blood culture requests were agitated for an additional 14 days. During this time they were subcultured twice and read twice by BACTEC NR 660. On days 1 to 7, 81 bottles were culture positive for yeasts from 36 patients, which included 44 isolates of Candida albicans, averaging 1.4 days to detection, and 12 isolates of Cryptococcus neoformans, averaging 3.8 days to detection. The average detection time for all yeasts was 2.2 days. On days 7 to 21, no yeasts were detected by BACTEC or recovered from the subcultures. We conclude that when continuously agitated for at least 5 full days (120 h), the BACTEC NR 660 aerobic resin bottles reliably isolate yeasts, and it is unnecessary to subculture or hold these bottles beyond 5 days. It also eliminates the need for an additional blood culture system for yeast detection, thus saving (i) confusion in the collection process, (ii) patients' blood and money, and (lii) laboratory technologists' time.

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Impact of the BACTEC NR system in detecting Candida fungemia

Cited by 14 publications

References 22 publications

Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus 26 aerobic blood culture bottle, and 10-milliliter isolator blood culture system for detection of fungemia and bacteremia

Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus 26 aerobic blood culture bottle, and 10-milliliter isolator blood culture system for detection of fungemia and bacteremia

BACTEC high-blood-volume fungal medium versus Isolator comparison misleading

Value of extended agitation and subculture of BACTEC NR 660 aerobic resin blood culture bottles for clinical yeast isolates

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