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Abstract
Background
We investigated whether culture using an automated blood culture system enhances the recovery of bacteria and fungi from body fluids other than blood when compared to conventional solid media culture methods.
Methods
A total of 734 specimens [ascites (n=457), bile (n=5), CAPD (n=28), CSF (n=32), joint fluids (n= 165), pericardial fluid (n=17), and pleural fluid (n=30)] were included in the study. Half of the volume of each specimen was inoculated directly into automated blood culture bottles (bioMeriux, Marcy-I'Etoile, France). The remaining volume was inoculated onto conventional solid media (sheep blood agar, chocolate agar, and phenylethyl alcohol agar) after centrifuging at 3,000 rpm for 10 min.
Results
Clinically significant microorganisms were isolated from 62 specimens (8.5%) by automated blood culture and 61 specimens (8.3%) by the conventional solid media culture (kappa index: 0.81, 95% confidence interval: 0.75∼0.89). Contamination was observed in 11 (1.8%) of the automated blood culture specimens and 3 (0.4%) of the solid media culture specimens. The mean turnaround times of the automated blood cultures and the conventional solid media cultures were 3.7 and 2.8 days, respectively (P＜ 0.0001).
REFERENCES
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Table 1.
Number of isolates by automatic blood culture system (BC) and solid media culture methods (SM)
| Test | Ascite BC/SM | Bile BC/SM | CAPD BC/SM | CSF BC/SM | JF BC/SM | PcF BC/SM | PF BC/SM | Total BC/SM |
|---|---|---|---|---|---|---|---|---|
| Clinically significant issolates | ||||||||
| S. aureus | 1/0 | 0/1 | 1/0 | 18/19 | 2/2 | 22/22 | ||
| Streptococcus spp.∗ | 0/1 | 6/7 | 6/8 | |||||
| Enterococcus spp.† | 0/1 | 1/1 | 1/1 | 2/3 | ||||
| S. pneumoniae | 1/1 | 1/1 | ||||||
| Enterobacteriaceae‡ | 9/7 | 3/3 | 3/2 | 1/1 | 1/1 | 1/0 | 18/14 | |
| P. aeruginosa | 2/3 | 1/0 | 3/3 | 6/5 | ||||
| Fungus§ | 1/1 | 2/2 | 1/1 | 4/4 | ||||
| Nocardia spp. | 1/1 | 1/1 | ||||||
| M. abscessus | 1/1 | 1/1 | ||||||
| Bacteroides spp. | 1/1 | 1/1 | ||||||
| Subtotal | 12/11 | 4/4 | 6/6 | 3/3 | 29/30 | 8/7 | 62/61 | |
| Contaminants | ||||||||
| CNS∥ | 1/0 | 3/1 | 2/0 | 3/1 | 1/0 | 10/2 | ||
| Gram+bacilli | 1/1 | 1/1 | ||||||
| Subtotal | 2/1 | 3/1 | 2/0 | 3/1 | 1/0 | 11/3 | ||
| No growth | 443/445 | 1/1 | 19/21 | 27/29 | 133/134 | 16/17 | 22/23 | 661/670 |
| Total | 457/457 | 5/5 | 28/28 | 32/32 | 165/165 | 17/17 | 30/30 | 734/734 |
Table 2.
Discrepancy of results in automated blood culture system and solid media culture methods
| Solid media | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Liquid media | Ascite | Bile | CAPD | CSF | JF | PcF | PF | Total | ||||||||
| + | − | + | − | + | − | + | − | + | − | + | − | + | − | + | − | |
| + | 10 | 4 | 4 | 0 | 7 | 5 | 2 | 3 | 29 | 4 | 0 | 0 | 7 | 1 | 59 | 17 |
| − | 2 | 441 | 0 | 1 | 1 | 15 | 1 | 26 | 2 | 130 | 1 | 16 | 0 | 22 | 7 | 651 |
Table 3.
Agreement (Kappa index)∗ of automated blood culture system and solid media culture methods
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