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

Jin Young Lee; Jong Hee Hong; Miae Lee

doi:10.5145/KJCM.2010.13.4.151

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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

Original Article

Korean J Clin Microbiol 2010;13(4):151-156.

Published online: 21 December 2010

DOI: https://doi.org/10.5145/KJCM.2010.13.4.151

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

Jin Young Lee, Jong Hee Hong, Miae Lee

Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea

Correspondence: Miae Lee, Department of Laboratory Medicine, Mokodong Hospital, Ewha Womans’ Universitiy School of Medicine, 911-1 Mokdong, Yangcheon-gu, Seoul 158-710, Korea. (Tel) 82-2-2650-5222, (Fax) 82-2-2650-5222, (E-mail) miae@ewha.ac.kr

Received 11 May 2010 Revised 16 June 2010 Accepted 20 August 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Blood culture, Antimicrobial removal system, BACTEC Plus Aerobic/F, BacT/Alert FA

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Fig. 1.

Overall recovery rates from growth controls and test bottles for the BACTEC Plus and BacT/Alert FA system.

Fig. 2.

Overall recovery rates of organisms in BACTEC Plus Aerobic/F and BacT/Alert FA bottles containing antimicrobials.

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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