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KMID : 1142720230260040125
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Annals of Clinical Microbiology
2023 Volume.26 No. 4 p.125 ~ p.137
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Performance evaluation of 4-day versus 5-day blood cultures using the BD BACTEC FX system
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Kim Ji-Yeon
Sung Heung-Sup
Kim Mi-Na
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Abstract
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Background: Blood culture (BC) systems have evolved to increase sensitivity and reduceturnaround times. This study compared the performance of a 4-day versus a 5-day BCincubation period using the BD BACTEC™ FX (Becton, Dickinson and Company, USA).
Methods: A total of 37,379 consecutive sets of BC were evaluated over a 3-month period in a2,700-bed tertiary care hospital. Positive BC results were reviewed to assess time-to-positivity(TTP) and species identification of the isolates. The BCs were performed in pairs of vials,utilizing either BD BACTEC Plus Aerobic/F or Peds Plus/F with BD BACTEC Lytic Anaerobicmedia.
Results: A total of 14,899 episodes, averaging 2.51 sets per episode, were analyzed. Of these,1,398 (9.38%) were positive, yielding 1,465 isolates. TTP (hours) were < 12 in 48.87%, 12-24in 31.40%, 24-48 in 13.38%, 48-72 in 3.28%, 72-96 in 1.43%, and >96 in 1.64%. The two mostprevalent organisms, Escherichia coli and Klebsiella spp. were detected within 12 hours in88.75% and 78.90%, respectively. The respective median TTP (T50) values for E. coli, Klebsiellaspp., Enterococcus faecalis/E. faecium, and Staphylococcus aureus were 9.24, 9.60, 13.75,and 14.20. T50 values for these species were significantly shorter in anaerobic bottles than inaerobic bottles. Of 24 BCs with TTP > 96, only 4 containing anaerobic bacteria or molds werefirst detected after 96 hours.
Conclusion: A 4-day incubation has demonstrated excellent sensitivity. However, a 5-dayincubation may be beneficial for hospitals caring for patients at high risk for infections withslow-growing fungi or fastidious bacteria.
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KEYWORD
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Anaerobic bacteria, Blood culture, Fungi, Incubation, Times to positivity
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