Journal List > Ann Clin Microbiol > v.17(2) > 1078509

Song, Kim, Shin, Kim, Lee, Kim, and Kim: Clinical Usefulness of Routine Use of Anaerobic Blood Culture Bottle

초록

Background

Blood culture for diagnosis of bacteremia and fungemia comprises aerobic and anaerobic cultures. The clinical utility of routine anaerobic blood culture has been questioned for a long time and was evaluated in this study.

Methods

A total of 9,028 positive blood cultures were collected from adults at four university-affiliated hospitals. We recorded the species distribution according to growth in aerobic or anaerobic culture.

Results

Among the 9,028 positive results, 3,239 cases (35.9%) occurred in aerobic culture, 1,543 cases (17.1%) in anaerobic culture and 4,246 cases (47.0%) in both cultures. The species grown only in the anaerobic cultures consisted of 81.4% facultative anaerobes, 2.0% strict anaerobes, 8.5% strict aerobes, and 8.1% yeasts.

Conclusion

Routine use of paired aerobic/anaerobic blood culture is essential because a considerable number of facultative anaerobes and yeasts grow only in anaerobic blood culture. Strict aerobes and fungi were more commonly isolated in the anaerobic bottles than were strict anaerobes.

REFERENCES

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Table 1.
Proportion (No.) of isolates grown in the aerobic and anaerobic blood culture bottles analyzed by hospital, equipment, and blood culture bottles
Hospital A B C D
Only in aerobic bottles 36.6% (730/1992) 34.7% (964/2779) 29.8% (583/1958) 41.8% (962/2299)
Only in anaerobic bottles 15.6% (311/1992) 20.9% (581/2779) 15.1% (295/1958) 15.5% (356/2299)
Both 44.7% (951/1992) 44.4% (1234/2779) 55.2% (1080/1958) 42.7% (981/2299)
Equipment BACTEC9240 system BacT/Alert 3D system
Only in aerobic bottles 34.7% (964/2779) 36.4% (2275/6249)
Only in anaerobic bottles 20.9% (581/2779) 15.4% (962/6249)
Both 44.4% (1234/2779) 48.2% (3012/6249)
Blood culture bottles BACTEC Plus Aerobic/F+ Lytic Anaerobic/F BacT/Alert FAN aerobic+ FAN anaerobic BacT/Alert SA+SN
Only in aerobic bottles 34.7% (964/2779) 39.4% (1692/4291) 29.8% (583/1958)
Only in anaerobic bottles 20.9% (581/2779) 15.6% (667/4291) 15.1% (295/1958)
Both 44.4% (1234/2779) 45.0% (1932/4291) 55.2% (1080/1958)
Table 2.
Number (%) of gram-positive bacteria grown in the aerobic and anaerobic blood culture bottles
Microorganisms Only in aerobic bottles Only in anaerobic bottles Both Total
Gram-positive cocci
Stapylococcus aureus 218 (21.2) 167 (16.2) 644 (62.6) 1,029
Stapylococcus epidermidis 215 (24.3) 246 (27.9) 422 (47.8) 883
Stapylococcus hominis 148 (78.3) 9 (4.8) 32 (16.9) 189
Stapylococcus captis 70 (46.7) 29 (19.3) 51 (34.0) 150
Stapylococcus haemolyticus 52 (55.3) 6 (6.4) 36 (38.3) 94
Stapylococcus, others 154 (44.0) 71 (20.3) 125 (35.7) 350
Streptococcus pneumoniae 16 (24.2) 8 (12.1) 42 (63.6) 66
Streptococcus mitis 17 (26.6) 8 (12.5) 39 (60.9) 64
Streptococcus agalactiae 11 (18.3) 7 (11.7) 42 (70.0) 60
Streptococcus anginosus 3 (8.6) 10 (28.6) 22 (62.9) 35
Streptococcus pyogenes 5 (27.8) 0 0.0 13 (72.2) 18
Streptococcus, others 37 (22.4) 34 (20.6) 94 (57.0) 165
Enterococcus faecium 109 (22.5) 103 (21.2) 273 (56.3) 485
Enterococcus faecalis 31 (15.9) 44 (22.6) 120 (61.5) 195
Enterococcus, others 9 (17.0) 18 (34.0) 26 (49.1) 53
Micrococcus spp. 40 (93.0) 3 (7.0) 0 (0.0) 43
 Others 15 (37.5) 10 (25.0) 15 (37.5) 40
 Subtotal 1,150 (29.3) 773 (19.7) 1,996 (50.9) 3,919
Gram-positive bacilli
Bacillus spp. 106 (54.9) 52 (26.9) 35 (18.1) 193
Corynebacterium spp. 32 (78.0) 6 (14.6) 3 (7.3) 41
 Others 22 (55.0) 14 (35.0) 4 (10.0) 40
 Subtotal 160 (58.4) 72 (26.3) 42 (15.3) 274
Table 3.
Number (%) of gram-negative bacteria grown in the aerobic and anaerobic blood culture bottles
Microorganisms Only in aerobic bottles Only in anaerobic bottles Both Total
Gram-negative bacilli Eeterobacteriaceae
Escherichia coli 294 (18.2) 264 (16.3) 1,061 (65.5) 1,619
Klebsiella penumoniae 159 (17.0) 136 (14.6) 638 (68.4) 933
Klebsiella oxytoca 10 (19.2) 11 (21.2) 31 (59.6) 52
Enterobacter cloacae 30 (20.7) 14 (9.7) 101 (69.7) 145
Enterobacter aerogenes 12 (17.4) 10 (14.5) 47 (68.1) 69
Serratia marcescens 13 (28.9) 4 (8.9) 28 (62.2) 45
Citrobacter freundii 8 (21.1) 8 (21.1) 22 (57.9) 38
Salmonella spp. 8 (28.6) 2 (7.1) 18 (64.3) 28
Salmonella Typhi 2 (18.2) 0 (0.0) 9 (81.8) 11
Proteus mirabilis 3 (11.5) 6 (23.1) 17 (65.4) 26
Morganella morganii 1 (11.1) 5 (55.6) 3 (33.3) 9
 Others 8 (16.3) 3 (6.1) 38 (77.6) 49
 Subtotal 548 (18.1) 463 (15.3) 2,013 (66.6) 3,024
Non-fermentative bacteria
Pseudomonas aeruginosa 292 (88.8) 9 (2.7) 28 (8.5) 329
Acinectobacter baumannii 174 (89.7) 1 (0.5) 19 (9.8) 194
Stehotrophomonas maltophilia 106 (97.2) 1 (0.9) 2 (1.8) 109
Achromobacter xylosoxidans 12 (92.3) 0 (0.0) 1 (7.7) 13
Chryseobacterium meningosepticum 12 (100.0) 0 (0.0) 0 (0.0) 12
Chryseobacterium indologenes 10 (100.0) 0 (0.0) 0 (0.0) 10
Burkholderia cepacia 10 (100.0) 0 (0.0) 0 (0.0) 10
 Others 76 (81.7) 5 (5.4) 12 (12.9) 93
 Subtotal 692 (89.9) 16 (2.1) 62 (8.1) 770
Other Gram-negative bacilli
Aeromonas hydrophila 5 (9.8) 7 (13.7) 39 (76.5) 51
Vibrio vulnificus 0 (0.0) 2 (16.7) 10 (83.3) 12
 Others 21 (40.4) 16 (30.8) 15 (28.8) 52
 Subtotal 26 (22.6) 25 (21.7) 64 (55.7) 115
Gram-negative coccobacilli
Haemophilus spp. 4 (28.6) 3 (21.4) 7 (50.0) 14
Table 4.
Number (%) of anaerobic bacteria and fungi grown in the aerobic and anaerobic blood culture bottles
Microorganisms Only in aerobic bottles Only in anaerobic bottles Both Total
Strict anaerobes
Bacteroides fragilis 0 (0.0) 46 (100.0) 0 (0.0) 46
Bacteroides spp. 0 (0.0) 27 (96.4) 1 (3.6) 28
Propionibacterium acnes 2 (8.0) 21 (84.0) 2 (8.0) 25
Clostridium spp. 0 (0.0) 25 (100.0) 0 (0.0) 25
Clostridium perfrigens 0 (0.0) 15 (100.0) 0 (0.0) 15
Prevotella spp. 0 (0.0) 17 (100.0) 0 (0.0) 17
Peptostreptococcus spp. 0 (0.0) 14 (100.0) 0 (0.0) 14
Fusobacterium spp. 0 (0.0) 13 (100.0) 0 (0.0) 13
 Subtotal 2 (1.1) 178 (97.3) 3 (1.6) 183
Fungi
Candida albicans 266 (96.7) 1 (0.4) 8 (2.9) 275
Candida tropicalis 134 (100.0) 0 (0.0) 0 (0.0) 134
Candida glabrata 57 (51.8) 11 (10.0) 42 (38.2) 110
Candida parapsilosis 102 (95.3) 0 (0.0) 5 (4.7) 107
Candida guilliermondii 13 (100.0) 0 (0.0) 0 (0.0) 13
Candida utilis 10 (100.0) 0 (0.0) 0 (0.0) 10
Candida pelliculosa 9 (100.0) 0 (0.0) 0 (0.0) 9
Candida, other 44 (100.0) 0 (0.0) 0 (0.0) 44
Trichosporon ashahii 4 (100.0) 0 (0.0) 0 (0.0) 4
Cryptococcus neoformans 4 (100.0) 0 (0.0) 0 (0.0) 4
 Others 14 (73.7) 1 (5.3) 4 (21.1) 19
 Subtotal 657 (90.1) 13 (1.8) 59 (8.1) 729
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