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Kim, Byun, and Kim: Effect of Delayed Entry on Time to Detection for the Lactose Nonfermentative Gram-Negative Rods
Original Article

Annals of Clinical Microbiology 2017; 20(1): 7-12.

Published online: 21 March 2017

DOI: https://doi.org/10.5145/ACM.2017.20.1.7

Effect of Delayed Entry on Time to Detection for the Lactose Nonfermentative Gram-Negative Rods

Seung-Wook Kim1, *, Jung-Hyun Byun2, *, Sunjoo Kim2

1Convergence of Medical Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.

2Department of Laboratory Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.

Correspondence: Sunjoo Kim, Department of Laboratory Medicine, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju 52727, Korea. (Tel) 82-55-214-3072, (Fax) 82-55-214-3087, sjkim8239@hanmail.net

Equal contributor:

*These authors contributed equally to this work.

Received 31 January 2017       Revised 7 March 2017       Accepted 7 March 2017

© 2017 The Korean Society of Clinical Microbiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Prolonged transport or poor accessibility of blood culture equipment during night time may cause delayed entry of blood culture bottles. The effect of prestorage conditions on time to detection (TTD) for the blood culture was evaluated for the important gram-negative lactose nonfermentative bacteria.

Methods

Three different clinical isolates of Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, and Burkholdera cepacia were diluted to 150 CFU/mL and 15 CFU/mL and inoculated into standard aerobic bottles. These were stored at 25℃ and at 37℃ for 0, 6, 12, 18, and 24 h. They were entered to BacT/Alert 3D Systems (bio-Mérieux Inc.) and TTD was monitored for each condition.

Results

At the 150 CFU/mL concentration, P. aeruginosa and A. baumannii showed false-negative for the bottles prestored at 37℃ for 18 h and 24 h, respectively. However, there was no false-negative for S. maltophilia or B. cepacia at any prestorage conditions. There was a significant decrease of TTD for all experimental microorganisms except P. aeruginosa prestored for 24 h either at 25℃ or at 37℃ (P< 0.05).

Conclusion

Delayed entry may cause false-negative, especially for the high level of bacteremia of P. aeruginosa or A. baumannii when the bottles are stored at 37℃ for ≥18 h. TTD could be reduced by prestorage of the bottles at 37℃ until 12 h without false-negative for nonfermentative bacteria.

Keywords: Bacteremia, Delayed entry, Pseudomonas, Sepsis, Time to detection

Figures and Tables

Fig. 1

Time to detection (TTD) of Pseudomonas aeruginosa of standard aerobic bottles stored at 25℃ and at 37℃ prior to insertion to BacT/Alert 3D blood culture system. Bacterial concentration: (A) 1.5×102/mL, (B) 1.5×101/mL.

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Fig. 2

Time to detection (TTD) of Acinetobacter baumannii of standard aerobic bottles stored at 25℃ and at 37℃ prior to insertion to BacT/Alert 3D blood culture system. Bacterial concentration: (A) 1.5×102/mL, (B) 1.5×101/mL.

acm-20-7-g002
Fig. 3

Time to detection (TTD) of Stenotrophomonas maltophilia of standard aerobic bottles stored at 25℃ and at 37℃ prior to insertion to BacT/Alert 3D blood culture system. Bacterial concentration: (A) 1.5×102/mL, (B) 1.5×101/mL.

acm-20-7-g003
Fig. 4

Time to detection (TTD) of Burkholderia cepacia of standard aerobic bottles stored at 25℃ and at 37℃ prior to insertion to BacT/Alert 3D blood culture system. Bacterial concentration: (A) 1.5×102/mL, (B) 1.5×101/mL.

acm-20-7-g004

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