Journal List > Korean J Clin Microbiol > v.13(4) > 1038199

Lee, Hong, and Lee: Comparison of BACTEC Plus Aerobic/F Media and BacT/ Alert FA Media to Detect Bacteria in Blood Culture Bottles Containing Peak Therapeutic Levels of Antimicrobials

Abstract

Background

Blood culture bottles with an antimicrobial removal system have been developed for patients treated with antibiotics. This study compared the ability of BACTEC Plus Aerobic/F bottles (Becton Dickinson, USA, BACTEC Plus) and BacT/Alert FA bottles (bio-Merieux Vitek, France) to effectively remove antimicrobials.

Methods

BACTEC Plus and BacT/Alert FA bottles were spiked with 5 mL human blood, peak therapeutic concentrations of 9 antimicrobials and 7 type strains. Three rounds of duplicate testing were completed per antimicrobial/strain combination and growth control without antimicrobials. The time to detection (TTD) and recovery rates for bacteria were compared for both systems.

Results

Overall, the BACTEC Plus and BacT/Alert FA recovered 76% (128/168) and 34% (57/168) of strains from test bottles, respectively. BACTEC Plus detected all of gram-positive bacteria except S. pneumoniae with ampicillin and ceftriaxone, but BacT/Alert FA detected 0∼50% of gram-positive bacteria except E. faecalis with vancomycin and methicillin-resistant S. aureus with oxacillin. In presence of cefepime, cefotaxime, cefoxitin and ceftriaxone, BACTEC Plus detected 33∼100% of gram-negative bacteria, but BacT/ Alert FA did not detect gram-negative bacteria at all. In presence of ciprofloxacin, BacT/Alert FA detected 100% of E. coli and K. pneumoniae compared with 33% of those for BACTEC Plus. Overall, TTD of BACTEC Plus was shorter than that of BacT/Alert FA except in detecting gram-negative bacteria with ciprofloxacin (P<0.05).

Conclusion

BACTEC Plus Aerobic/F media containing peak therapeutic levels of antimicrobials are more effective and faster detection of bacteria than BacT/ Alert FA media.

REFERENCES

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Fig. 1.
Overall recovery rates from growth controls and test bottles for the BACTEC Plus and BacT/Alert FA system.
kjcm-13-151f1.tif
Fig. 2.
Overall recovery rates of organisms in BACTEC Plus Aerobic/F and BacT/Alert FA bottles containing antimicrobials.
kjcm-13-151f2.tif
Table 1.
Combinations of strain/antimicrobials used in this study
Strains Antimicrobials
S. aureus Vancomycin, oxacillin, cefoxitin
MRSA Vancomycin, oxacillin
MRSA-c Vancomycin, oxacillin
S. pneumoniae Vancomycin, ampicillin, cefoxitin, ciprofloxacin
E. faecalis Vancomycin, ampicillin
E. coli Gentamicin, cefepime, ciprofloxacin, cefotaxime, cefoxitin, ceftriaxone
K. pneumoniae Gentamicin, cefepime, ciprofloxacin, cefotaxime, cefoxitin, ceftriaxone
P. aeruginosa Gentamicin, cefepime, ciprofloxacin

Abbreviations: MRSA, methicillin resistant Staphylococcus aureus; MRSA-c, clinical isolated MRSA.

Table 2.
Recovery rates (%) and time to detection (mean±SD) of gram-positive bacteria for BACTEC Plus and BacT/Alert FA at each antimicrobials
Antimicrobials No. (%) of growth positive bottles
S. auureus MRSA MRSA-c S. pneumoniae E. faecalis
BACTEC BacT/Alert BACTEC BacT/Alert BACTEC BacT/Alert BACTEC BacT/Alert BACTEC BacT/Alert
VANN (RR) 6 (100) 2 (33) 6 (100) 1 (17) 6 (100) 3 (50) 6 (100) 1 (17) 6 (100) 6 (100)
 TTD 14.7±1.4 18.1±3.2 36.8±2.7 50.1±0.0 17.8±1.4 22.1±2.6 16.2±1.4 13.5±0.0 11.4±0.2 13.2±0.7
AMPRR NT NT NT NT NT NT 2 (33) 0 (0) 6 (100) 0 (0)
 TTD NT NT NT NT NT NT 63.8±0.2 No growth 14.1±1.9 No growth
 OXAN (RR) 6 (100) 0 (0) 6 (100) 2 (33) 6 (100) 6 (100) NT NT NT NT
 TTD 21.9±3.1 No growth 39.8±7.4 34.5±1.9 18.1±4.3 24.2±2.7 NT NT NT NT
FOX N (RR) 6 (100) 0 (0) NT NT NT NT 6 (100) 0 (0) NT NT
 TTD 14.9±0.6 No growth NT NT NT NT 11.9±0.9 No growth NT NT
CRON (RR) NT NT NT NT NT NT 2 (33) 0 (0%) NT NT
 TTD NT NT NT NT NT NT 64.5±0.0 No growth NT NT
Ctrl N (RR) 6 (100.0) 6 (100.0) 6 (100.0) 6 (100.0) 6 (100) 6 (100) 6 (100) 6 (100) 6 (100) 6 (100)
 TTD 12.1±0.5 13.2±0.5 32.5±3.4 30.0±1.4 14.8±1.4 15.5±1.8 10.4±0.5 12.3±0.6 10.8±0.7 13.5±0.5

P<0.05

P≥0.05.

Abbreviations: BACTEC, BACTEC Plus Aerobic/F; BacT/Alert, Bact/Alert FA; VAN, vancomycin; AMP, ampicillin; OXA, oxacillin; FOX, cefoxitin; CRO, ceftriaxone; Ctrl, control; MRSA, methicillin resistence S. aureus; MRSA-c, clinical isolate of MRSA; N, number of growth positive bottles; RR, recovery rate; TTD, time to detection (hours); NT, not tested.

Table 3.
Recovery rates (%) and time to detection (mean±SD) of gram-negative bacteria for BACTEC Plus and BacT/Alert FA at each antimicrobials
Antimicrobials No. (%) of growth positive bottles
  E. coli K. pneumoniae P. aeruginosa
BACTEC BacT/Alert BACTEC BacT/Alert BACTEC BacT/Alert
Gentamicin N (RR) 6 (100) 6 (100) 6 (100) 6 (100) 6 (100) 6 (100)
  TTD 10.7±0.3 11.6±0.1 10.6±0.3 12.0±0.2 14.0±0.9 15.1±0.7
Cefepime N (RR) 2 (33) 0 (0) 2 (33) 0 (0) 6 (100) 0 (0)
  TTD 39.8±0.6 No growth 40.0±0.4 No growth 24.9±6.4 No growth
Ciprofloxacin N (RR) 2 (33%) 6 (100%) 2 (33) 6 (100) 6 (100) 6 (100)
  TTD 39.7±0.5 13.6±1.1 39.5±0.2 12.3±0.4 21.6±11.6 15.2±0.7
Cefotaxime N (RR) 2 (33) 0 (0) 2 (33) 0 (0) NT NT
  TTD 39.2±0.2 No growth 39.4±0.5 No growth NT NT
Cefoxitin N (RR) 6 (100) 0 (0) 6 (100) 0 (0) NT NT
  TTD 10.5±0.8 No growth 10.6±0.3 No growth NT NT
Ceftriaxone N (RR) 2 (33) 0 (0) 2 (33) 0 (0) NT NT
  TTD 39.4±0.5 No growth 40.4±0.3 No growth NT NT
Control N (RR) 6 (100) 6 (100) 6 (100) 6 (100) 6 (100) 6 (100)
  TTD 10.7±0.2 11.7±0.1 10.4±0.4 12.0±0.3 13.9±1.4 15.2±0.5

P<0.05

P≥0.05. Abbreviations: BACTEC, BACTEC Plus Aerobic/F; BacT/Alert, Bact/Alert FA; N, number of growth positive bottles; RR, recovery rate; TTD, time to detection (hours); NT, not tested.

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