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

Kon-Hee Lee; Wonkeun Song; Min-Jeong Park; Jeongwon Hyun; Hyun Soo Kim; Kyu Man Lee

doi:10.5145/KJCM.2011.14.4.126

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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

Original Article

Korean J Clin Microbiol 2011;14(4):126-130.

Published online: 21 December 2011

DOI: https://doi.org/10.5145/KJCM.2011.14.4.126

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

Kon-Hee Lee¹, Wonkeun Song², Min-Jeong Park², Jeongwon Hyun², Hyun Soo Kim², Kyu Man Lee²

¹Department of Pediatrics, Hallym University College of Medicine, Seoul, Korea

²Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, Korea

Correspondence: Wonkeun Song, Department of Laboratory Medicine, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, 948-1 Daerim 1-dong, Yeongdeungpo-gu, Seoul 150-950, Korea. (Tel) 82-2-829-5259, (Fax) 82-2-847-2403, (E-mail) swon-keun@hallym.or.kr

Received 25 July 2011 Revised 21 September 2011 Accepted 10 October 2011

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

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.

Keywords: Pediatric blood culture, BACTEC Peds Plus, BacT/Alert PF

REFERENCES

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Fig. 1.

Plot of time to detection in BACTEC Peds Plus and BacT/ Alert PF pediatric blood culture bottles.

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
Patient weight (kg)	Volume (mL) needed	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
Rate	BacT/Alert PF	BACTEC Peds Plus	P value
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
Organism group	Both	BacT/Alert PF	BACTEC Peds	P value
	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
Organism group	No. of isolates	BacT/Alert PF	BACTEC Peds Plus	P value
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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