Journal List > Korean J Clin Microbiol > v.14(4) > 1038227

Lee, Song, Park, Hyun, Kim, and Lee: Comparison of the BACTEC Peds Plus Pediatric Blood Culture Bottle to the BacT/Alert PF Pediatric Blood Culture Bottle for Culturing Blood from Pediatric Patients

Abstract

Background

We compared the BACTEC Peds Plus (Becton Dickinson, USA) and BacT/Alert PF (bioMeri-eux, France) pediatric blood culture bottles in the context of recovery and time to detection (TTD) of bacteria and fungi from pediatric patients.

Methods

Blood samples were collected for culture from pediatric patients who were hospitalized during 2010 at a university hospital. BACTEC Peds Plus and BacT/Alert PF bottles were placed in the BACTEC FX and BacT/Alert 3D blood culture system, respectively, and tested for 5 days. Bottles flagged by instruments as positive were removed from the instruments and the TTDs were recorded.

Results

A total of 5,018 sets (1 set, 1 BACTEC Peds Plus and 1 BacT/Alert PF) were evaluated. Overall, the recovery proportions for BACTEC Peds Plus and BacT/Alert PF bottles were 57% (134/195) and 69% (112/195), respectively. There was a significant differ-ence between the 0.38% contamination rate in BacT/ Alert PF bottles and the 0.16% contamination rate in BACTEC Peds Plus bottles (P=0.035). The average TTD for all microorganisms was significantly decreased for the BACTEC Peds Plus bottles (P=0.021), but was increased for Candida parapsilosis compared to the results for the BacT/Alert PF bottles (P=0.028).

Conclusion

We conclude that the rate of detection and contamination is higher when BacT/Alert PF bottles are used than when BACTEC Peds Plus bottles are used for pediatric blood culture. The BACTEC Peds Plus bottles detect nearly all enrolled microorganisms significantly faster than do the BacT/Alert PF bottles.

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Fig. 1.
Plot of time to detection in BACTEC Peds Plus and BacT/ Alert PF pediatric blood culture bottles.
kjcm-14-126f1.tif
Table 1.
Volume of blood required for an adequate blood culture based on patient's weight
Patient weight (kg) Volume (mL) needed Blood culture set: volume (mL) drawn
BacT/Alert PF BACTEC Peds Plus
1-3 1 0.5 0.5
3.1-6 2 1.0 1.0
6.1-9 4 2.0 2.0
9.1-12 6 3.0 3.0
12.1-20 8 4.0 4.0
20.1-25 10 5.0 5.0
Table 2.
Rate of positivity, false positive, and contamination
Rate % (no.) of: P value
BacT/Alert PF BACTEC Peds Plus
Positivity 2.67% (134) 2.23% (112) NS
False positive 0.32% (16) 0.16% (8) NS
Contamination 0.38% (19) 0.16% (8) 0.035

Total No. of isolates in an instrument/total No. of vials.

Include instrument positive and subculture negative; total No. of false positive

Include micrococci, Bacillus spp., and vials/total No. of vials.

Corynebacterium spp. isolated; total No. of contamination vials/total No. of vials.

Abbreviation: NS, not significant.

Table 3.
Recovery of bacteria and yeasts from BacT/Alert PF and BACTEC Peds Plus pediatric blood culture bottles
Organism group No. of isolates recovered from: P value
Both BacT/Alert PF BACTEC Peds
  bottles bottle only Plus bottle only  
Gram-positive cocci 34 55 36 <0.001
 Coagulase-negative staphylococci 20 44 31 <0.001
 Staphylococcus aureus 3 1 0 NS
 Enterococci 3 2 0 NS
 Streptococci 8 8 5 0.002
Other gram-positive bacteria 0 19 8 <0.001
 Micrococci 0 15 5 <0.001
 Bacillus spp. 0 3 2 NS
 Corynebacterium spp. 0 1 1 NS
Enterobacteriaceae 7 4 3 NS
Nonfermenters 0 2 9 0.018
Other gram-negative bacteria 1 2 4 NS
Candida parapsilosis 6 1 1 NS
Others§ 3 0 0 NS
All microorganisms 51 83 61 <0.001

Includes 7 Escherichia coli, 5 Salmonella spp., 1 Klebsiella ozaenae, and 1 Enterobacter sakazakii. Chryseobacterium indologenes, 1 Pseudomonas luteola, 3 Rhizobium radiobacter, and 3 Sphingomonas paucimobilis.

Includes 2 Aeromonas salmonicida, 4 Neisseria spp., and 1 Moraxella spp.

§ Includes different isolates isolated in each other bottles: 1 micrococci vs. A. salmonicida, 1 S. paucimobilis vs. coagulase-negative staphylococci, and 1 E. faecalis vs. S. aureus. Abbreviation: NS, not significant.

Includes 2 Acinetobacter spp., 2

Table 4.
Time to detection (TTD) of microbial growth for microorganisms recovered in BacT/Alert PF and BACTEC Peds Plus pediatric blood culture bottles
Organism group No. of isolates Average (range) TTD (h) P value
BacT/Alert PF BACTEC Peds Plus
Gram-positive cocci 34 25.6 (6.6-60.7) 18.5 (4.4-46.6) 0.006
 Coagulase-negative staphyloco occi 20 32.2 (17.4-60.7) 23.7 (7.1-46.6) NS
 S. aureus 3 13.7 (6.6-18.8) 11.0 (4.4-15.9) NS
 Enterococci 3 16.3 (14.0-19.9) 14.1 (10.2-21.3) NS
 Streptococci 8 16.9 (7.8-44.6) 10.1 (5.8-18.7) 0.012
Enterobacteriaceae 7 15.0 (8.5-19.5) 11.1 (1.7-17.2) 0.004
 E. coli 3 11.5 (8.5-13.2) 6.7 (1.7-10.1) NS
 Salmonella spp. 4 17.6 (15.0-19.5) 14.4 (11.9-17.2) NS
N. elongata 1 30.0 55.3 NS
C. parapsilosis 6 34.1 (23.5-42.4) 41.7 (25.6-58.9) 0.028
All microorganisms 48 25.2 (6.6-60.7) 21.1 (1.7-58.9) 0.021
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