Automated Blood Culture System Research Articles

A novel Colorcult hemoculture in early diagnosis of blood stream infection: A boon in meagre resources

Blood stream infections (BSIs) account for major cause of morbidity and mortality. Conventional hemoculture methods are time consuming, with poor sensitivity and high risk of contamination. Automated blood culture systems are highly sensitive but are overpriced. Hence, it is not suitable for resource poor settings. In this background, this study was done to analyze the sensitivity of novel non automated chemical sensor-based blood culture and to compare the time to detection of both conventional and colorimetric method of blood culture. Blood specimens were collected from 50 study participants, admitted with suspected sepsis, inoculated into the colorcult & conventional culture media and processed as per CLSI guidelines. Culture positive by both conventional and colorcult method was six (12%). Most of the study isolates were Gram negative bacteria (83.4%). The isolates were detected at the earliest within 96 hours by colorcult, whereas by conventional method only three (50 %) were detected within 96 hours and another three (50%) after seven days only. Owing to the escalation in BSIs associated morbidity and mortality, early diagnosis by a simple, cost effective, highly sensitive and specific method is an absolute necessity in resource poor settings. The performance of colorcult is superior to conventional method but cost effective than automated methods and can be used as an alternative method in the diagnosis of BSIs.

Influence of filtering on the effective concentration and sterility of a 2% cyclosporine ophthalmic solution: a quality improvement perspective

BackgroundPharmaceutical companies do not sell formulations for all diseases; thus, healthcare workers have to treat some diseases by concocting in-hospital preparations. An example is the high-concentration 2% cyclosporine A (CyA) ophthalmic solution. Utilizing a filter in sterility operations is a general practice for concocting in-hospital preparations, as is the case for preparing a 2% CyA ophthalmic solution. However, whether filtering is appropriate concerning the active ingredient content and bacterial contamination according to the post-preparing quality control of a 2% CyA ophthalmic solution is yet to be verified.MethodsWe conducted particle size, preparation concentration, and bacterial contamination studies to clarify aforementioned questions. First, we measured the particle size of CyA through a laser diffraction particle size distribution. Next, we measured the concentration after preparation with or without a 0.45-µm filter operation using an electrochemiluminescence immunoassay. Finally, bacterial contamination tests were conducted using an automated blood culture system to prepare a 2% CyA ophthalmic solution without a 0.45 μm filtering. Regarding the pore size of the filter in this study, it was set to 0.45 μm with reference to the book (the 6th edition) with recipes for the preparation of in-hospital preparations edited by the Japanese Society of Hospital Pharmacists.ResultsCyA had various particle sizes; approximately 30% of the total particles exceeded 0.45 μm. The mean ± standard deviation of filtered and non-filtered CyA concentrations in ophthalmic solutions were 346.51 ± 170.76 and 499.74 ± 76.95ng/mL, respectively (p = 0.011). Regarding bacterial contamination tests, aerobes and anaerobes microorganisms were not detected in 14 days of culture.ConclusionsDue to the results of this study, the concentration of CyA may be reduced by using a 0.45-µm filter during the preparation of CyA ophthalmic solutions, and furthermore that the use of a 0.45-µm filter may not contribute to sterility when preparing CyA ophthalmic solutions.

Short communication: first case of bacteraemia causedby Dielma fastidiosa in a patient hospitalized with diverticulitis.

Dielma fastidiosa is a gram-negative, anaerobic rod belonging to the family Erysipelotrichaceae. D. fastidiosa has previously been isolated in human stool samples as part of the commensal flora; however, prior to this case, it has never been identified as a human pathogen. We present the first case of bacteraemia with D. fastidiosa. Bacterial growth in the blood culture bottle was detected by the automated blood culture system BacT/ALERT 3D. Culturing was performed, and bacterial colonies were identified as D. fastidiosa using MALDI-TOF MS. A subsequent whole-genome sequencing using Illumina NovaSeq was performed, and a phylogenetic tree depicting all available sequences of D. fastidiosa was generated. The reference MALDI-TOF spectrum and species identification was compared with the previously published spectrum. Whole-genome sequencing confirmed the tentative MALDI-TOF species identification. Notably, the maximum-likelihood-based phylogenetic analysis placed the D. fastidiosa isolate from this clinical case within the known variation of the eight publicly available sequences of this species. We identified D. fastidiosa by whole-genome sequencing followed by maximum-likelihood analysis as a possible pathogen in this case of bacteraemia in a patient hospitalized with diverticulitis.

1106. Comparison of Diagnostic Power of Conventional Culture and Automated Blood Culture System with Pleural Fluid

Abstract Background Microbiological diagnosis of empyema is often hindered by low sensitivity of conventional culture. Automated blood culture system has been reported to enhance diagnostic power for culture of non-blood specimens. The purpose of this study is to compare the diagnostic power of conventional bacterial culture and automated blood culture system (ABCS) in patients who underwent thoracentesis or percutaneous drainage. Methods Non-duplicate patients whose pleural fluid was tested using both conventional culture and ABCS (BACT/ALERT 3D and VIRTUO, bioMerieux) from 1 Jan 2001 to 31 Dec 2021 were included. Cases in which coagulase-negative staphylococci were only positive isolates were excluded. Culture results, demographic information, and laboratory test results were obtained from the clinical data warehouse of Samsung Medical Center. The results from conventional cultures were compared against those from ABCS. Results A total of 9,020 patients who met the study criteria were identified. Among them, 819 patients had positive results other than coagulase-negative staphylococci from ABCS. Conventional culture was also positive in 360 (44.0%) patients, while 459 (56.0%) patients had isolates only from ABCS. Pleural fluid from female and the patients with no pre-existing pleural drainage were significantly more likely to be culture positive by ABCS only (Table 1 and 2). In addition, pleural fluid LDH and serum CRP were significantly lower and pleural fluid glucose was significantly high in the patients with positive results from ABCS only. Among organisms isolated from both conventional culture and ABCS, the most frequently identified species was Staphylococcus aureus, followed by Klebsiella spp., and viridans group streptococci (Figure 1). Viridans group streptococci, Candida spp., and S. aureus were the most common species isolated from ABCS only (Figure 1). Conclusion More than a half of the patients whose pleural fluid culture were positive using ABCS had a negative conventional culture. Viridans group streptococci, Candida spp., and S. aureus were common species causing the discrepancy. Our results suggest that ABCS may enhance microbiologic diagnosis of empyema. Disclosures All Authors: No reported disclosures

Bacterial Predominance and Antimicrobial Susceptibility Patterns of Blood Culture at a Tertiary Care Hospital, Bangladesh

Background: The problem of widespread resistant bacteria has become a major threat to reduce the effectiveness of antibiotics worldwide. Objective: The aim of this study was to identify the bacterial pathogens from bold culture and determine their antibiotic susceptibility pattern. Methodology: This cross-sectional study was conducted in the department of Microbiology at Monno Medical College, Manikganj, Bangladesh during the period from January 2019 to December 2019 for duration of one year. Blood was collected according to blood collection guidelines and inoculated into BacT/ALERT FA plus and BacT/ALERT PF plus aerobic blood culture bottles respectively. After collection these bottles were immediately incubated in BacT/ALERT 3D (manufactured by bioMerieoux, France) a fully automated blood culture system. Antimicrobial susceptibility test was done for all isolated bacteria by disc diffusion method. Results: A total number of 180 patients were recruited, among them 12 (7%) yielded growth of different bacteria. The most frequently isolated bacteria were Streptococcus Spp 5(42%) followed by Staphylococcus aureus and Escherichia coli which were 4(33%) and 3(25%) respectively. Escherichia Coli which showed highly sensitive to Imipenum, Amikacin, Linezolid, Gentamicin (N=3, 100%). Conclusion: There were a high percentage of bacteria isolated from blood culture and resistant to several antibiotics. For the selection of appropriate antibiotic therapy in bacterial infections the antibiotic susceptibility testing is mandatory. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):48-53

A Two-Year Surveillance of Central Line-Associated Bloodstream Infections in the Trauma ICU of a Tertiary Care Hospital in India.

Aim The aim of the study is to identify therisk factors and mortality associated with central line-associated bloodstream infection (CLABSI) and to investigate the incidence and associated etiology in trauma patients admitted to the trauma ICU (TICU) of a tertiary care teaching hospital in Northern India. Materials and methods The study was a prospective study conducted in the trauma ICU of a tertiary care teaching hospital in India from November 2020 to October 2022. Adult patients >18 years of age who were on central line for >48 hours were included in the study. The automated blood culture system BacT/ALERT 3D (bioMérieux, Durham, NC) was used for microbial detection from blood samples. We recorded patients' daily progress, and catheter-related data was collected and used as variables. All the data was analyzed using the Statistical Package for Social Sciences (SPSS)version 22.0 (IBM SPSS Statistics, Armonk, NY)to evaluate the risk factors associated with CLABSI. Result A total of516 admissions occurred during the surveillance period, out of which352 patients fulfilled the inclusion criteria and were enrolled in the study. Out of these 352 patients, a total of 74 patients developed central line-associated bloodstream infection (CLABSI). Thus, the incidence of CLABSI was 16.4 per 1000 central line days and 13.2 per 1000 inpatient days with a 0.8 device utilization ratio (DUR). The most common organisms isolated from these CLABSI cases were Acinetobacter species (23%), followed by Escherichia coli(16.5%) and Staphylococcus aureus(15.6%). The independent healthcare-associated risk factors for CLABSI were longer length of ICU stay and prolonged duration of central venous catheterization. The most common comorbidity associated withCLABSI was diabetes mellitus (20.3%), followed by hypertension (14.8%), and the mortality rate was 41.9%. Conclusion The healthcare-associated risk factors such as longer length of ICU stay and prolonged duration of central venous catheterization are the risk factors for developing central line-associated bloodstream infections (BSI).

Comparison of Bacterial Etiology with Antibiogram of Blood Stream Infection between Adult and Paediatric Group at a Tertiary Care Hospital in Bangladesh

Background: Timely understanding of bacterial profiles and the change of antimicrobial resistance provide an important guidance for effective and optimized use of antibiotics in local healthcare systems. Objective: The purpose of this study was to compare of bacterial etiology with antibiogram of blood stream infection between adult and paediatric. Methodology: This cross-sectional study was conducted in the department of Microbiology at Monno Medical College, Manikganj, Bangladesh during the period from January 2019 to December 2019 for duration of one year. In adult and pediatric patient blood was collected according to blood collection guidelines and inoculated into BacT/ALERT FA plus and BacT/ALERT PF plus aerobic blood culture bottles respectively. After collection these bottles were immediately incubated in BacT/ALERT 3D (manufactured by bioMerieoux, France) a fully automated blood culture system. Antimicrobial susceptibility test was done for all isolated bacteria by disc diffusion method. Result: A total number of 178 patients were recruited, among them 12 (7%) yielded growth of different bacteria. The culture positive cases were found in 7 (4%) in Paediatric group and 5 (3%) in adult age group. The most predominant identified bacteria in Paediatric group was Escherichia Coli which showed highly sensitive to imipenum, amikacin, linezolid, gentamicin (n=3, 100%). In adult group the most predominant isolated bacteria was Streptococci species which showed high sensitive to imipenum, linezolid, gentamicin 4 (80%) considerable sensitive to ciprofloxacin, tetracycline, cefotaxime, cefuroxime 3(60.0%). Conclusion: In conclusion the most common bacteria isolated from blood stream infection in adult and paediatric group are Streptococci species and Escherichia Coli respectively. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 869-875

Antimicrobial Profile and Prevalence of Salmonella Species from Blood Culture in A Tertiary Care Hospital

Background & Aim: Enteric fever is a major public health concern around the world and endemic in low- and middle-income countries like, India. Typically, it spreads through contaminated food or water. Salmonella Typhi proliferate and spread throughout the bloodstream seeding multiple organs in the body. Incidence data of culture confirmed Typhoid cases is approximately 377per 100000 population with an approximate case fatality rate of 1% in India. The management of cases are hampered due to emerging the drug resistance of isolates because of rampant and misuse of antibiotics. This study investigates to analyse the current pattern of antibiotic susceptibility among Salmonella isolates from cases of enteric fever seen at ESIC Medical College & Hospital, Faridabad.
 Material & Methods: This is a retrospective, cross-sectional study. Blood cultures from patients with suspected enteric fever from Jan 2017 to Dec 2019 were included. The blood cultures were processed using the BacT/Alert automated blood culture system.
 Results: During the study period, a total of 4064 blood culture specimens were received from the patients suspected for fever. Out of a total of 2717 culture positive samples, 373 (13.73%) were found positive for the growth of Salmonella enterica [Salmonella typhi 87.13% (325/373), Salmonella paratyphi A (12.86%)], confirming the enteric fever.
 Conclusion: Treatment with appropriate antimicrobial drugs is crucial for patients with typhoidal infections and the antimicrobial susceptibility of such isolates must be reported as soon as possible.

Bacterial Profile, Antimicrobial Susceptibility Patterns, and Associated Factors of Puerperal Sepsis in Asella, Central Ethiopia: A Cross-sectional Study

Sepsis, caused by various bacterial pathogens, is a significant contributor to maternal mortality worldwide. In many developing countries, including Ethiopia, empirical or syndromic treatment is commonly employed for puerperal sepsis, which may promote antimicrobial resistance (AMR). We conducted a cross-sectional study to investigate bacterial pathogens, their antimicrobial susceptibility patterns, and associated factors among women with suspected puerperal sepsis attending Asella Referral and Teaching Hospital from September 2020 to August 2021. A total of 174 participants were enrolled, and the sociodemographic and obstetric data were collected using a pretested structured questionnaire and checklist, respectively. Blood samples (approximately 20 ml) were collected from all study participants and incubated in BacT/ALERT® 3D automated blood culture system. In addition, endocervical swabs were collected in Amies transport media. Bacterial isolation and identification were performed following standard bacteriological methods. Antimicrobial susceptibility profiles of bacterial isolates were determined using the disc diffusion method. Data were entered into EpiData version 4.6 and analyzed using SPSS version 25.0. The overall positivity rate of bacterial isolates among puerperal sepsis-suspected women was 48.9%. Among these, 87.1% of the isolates were Gram-negative bacteria. The most common isolates were Escherichia coli (54.1%), followed by Klebsiella spp. (23.5%) and Staphylococci aureus (10.6%). High resistance rates were observed in E. coli to piperacillin (87%), in Klebsiella spp. to aztreonam (65%) and ceftriaxone (65%), and in S. aureus to trimethoprim-sulfamethoxazole (66.6%). Multidrug-resistant bacterial pathogens accounted for 81.2% of the isolates in this study. Multivariate regression analysis did not reveal any statistically significant association between the presence of bacteria and the sociodemographic and obstetrics factors. Our findings emphasize the urgency of strengthening microbiology services to optimize patient management and combat AMR in puerperal sepsis.

Clinical and Microbiology Profile of Typhoidal and Nontyphoidal Salmonella Blood Stream Infection: An Observational Study from a University Hospital

Abstract Background Species distribution and antibiotic resistance pattern of Salmonella varies with time and place. Rapid and correct use of antibiotics requires understanding of the distribution and drug resistance patterns. Therefore, we aimed to study the clinical profile of patients along with speciation and antibiogram of Salmonella isolates from blood. Material and Methods It is an observational study, conducted from December 2019 to December 2021 at our university hospital. Blood cultures were processed by automated blood culture system. Salmonella isolates were identified by their morphological properties, biochemical reaction, and serological tests. Antibiotic susceptibility pattern was assessed by Kirby–Bauer's disc diffusion method and Phoenix automated system. Results The male-to-female ratio of the patients in the study was 2.5:1 and the mean age of the patients was 11.7 years (1–27 years). Salmonella spp. was isolated from 21 patients out of 1,350 positive blood cultures. Nine isolates were identified as S. Typhi seven as S. Choleraesuis three as S. Paratyphi A and two as S. Paratyphi B. Immunocompromised conditions were significantly associated in nontyphoidal Salmonella bacteremia (p = 0.0253). Isolates showed maximum resistance toward nalidixic acid (100%) followed by fluoroquinolones (52.4%). Multidrug resistance, extreme drug resistance, and azithromycin resistance was seen in 14.3, 4.8, and 4.8% isolates, respectively. Posttreatment recovery was observed in 20 patients. Conclusion Emergence of S. Choleraesuis among Salmonella spp. in blood stream infection, next only to S. Typhi was noted. Rising drug resistance is a matter of concern.

Early Detection of Sepsis: Comparative Analysis of Conventional vs Automatic Blood Culture and Few Inflammatory Markers

Abstract: BACKGROUND: Blood cultures are important tools in microbiology laboratories to detect and identify microorganisms in blood and their susceptibility to antibiotics Inflammatory markers also give early indication of sepsis. It also has important prognostic relevance by recommending appropriate antibiotic therapy and start the antibiotic therapy empirically when indication of sepsis we get from inflammatory markers. Automated blood culture systems are replacing traditional methods and it is important to compare them to understand their advantages and compare it with inflammatory markers for early prediction probability. The current study compares sepsis prediction by inflammatory markers and microbial detection rates and time to detection between a recently installed automated BacT/ALERT system and conventional approaches. Inflammatory markers also give early signs of sepsis. Conducted at a tertiary care facility in Kolkata, this prospective observational study included patients with suspected bacteremia and sepsis.

Rapid Detection of Microorganisms by Automated Blood Culture System: Experience of 3220 cases of Blood Culture

Background: Blood culture is important for diagnosis of various diseases and isolation of micro-organisms. Objective: The purpose of the present study was to assess the rapid detection of microorganisms by automated blood culture system. Methodology: This retrospective study was conducted in the Department of Microbiology at Dhaka National Medical College, Dhaka, Bangladesh and IBN Sina D. Lab & Consultation center, Doyagonj, Dhaka, Bangladesh from January 2020 to December 2020 for a period of one year. All the patients presented with suspected cases of blood stream infection were selected as study population. Blood samples were collected from suspected cases. Results: A total of 3220 blood samples were collected from patients. Among them, bacteria were isolated 372(11.55%) cases. The most common isolated organisms were Salmonella typhi 276(74.2%), Salmonella paratyphi A 52(14%), Escherichia coli 21(5.6%), Pseudomonas species 14(3.8%), and Staphylococcus aureus, 9(2.4%). Salmonella typhi is the most common organisms and showed sensitivity pattern to imipenem 97.82% colistin 88.41%, amikacin 76.81% and ciprofloxacin 49.28%. Conclusion: In conclusion Salmonella typhi, Salmonella paratyphi A and Escherichia coli are the most common isolated bacteria from the blood stream infection. Bangladesh Journal of Infectious Diseases, June 2022;9(1):3-6

Etiology of Bacterial Sepsis and Isolate Resistance Patterns in Hospitalized Neonates in Zambia.

The Sepsis Prevention in Neonates in Zambia study is a prospective cohort study that evaluated an infection prevention and control (IPC) bundle in the University Teaching Hospital neonatal intensive care unit (NICU) in Lusaka, Zambia. We present here the etiologies, antimicrobial resistance profiles, and associated mortality of bloodstream infections (BSI) in this cohort. Venous blood was collected from neonates with clinically suspected sepsis and cultured with an automated blood culture system. Organism identification and susceptibility testing were done using the Vitek II system. We used the CDC National Health Safety Network criteria to define pathogens and commensals. There were 1120 blood cultures performed for 1060 neonates with suspected sepsis. Overall, 38% (424/1120) of cultures were positive of which 72% (306/424) grew pathogens. Blood cultures obtained after, as compared to before, 2 days of hospitalization were more likely to yield a pathogen (77% vs. 65%; P < 0.001). Klebsiella pneumoniae was the most prevalent organism, accounting for 74% (225/306) of all pathogens . K. pneumoniae isolates were highly resistant: 98% (221/225) were extended-spectrum beta-lactamase (ESBL)-positive, while 81% were resistant to gentamicin (182/225) and fluoroquinolones (177/219). Only one isolate was carbapenem resistant. Observed mortality rate was 32% (122/380); 61% (75/122) of the deaths was related to Klebsiella BSI. Multidrug-resistant ESBL-producing Klebsiella species were the main organisms responsible for BSI and were associated with increased mortality. BSI risk increased with prolonged hospitalization, underscoring the importance of IPC measures in the NICU.

False Positive Cases in Automated Blood Culture Systems Due to Hyperleukocytosis

Automated blood culture systems are widely used in clinical microbiology laboratories to minimize the workload of laboratory personnel and permit fast turnaround times. However, sometimes false positive signals occur due to leukocytosis, presence of fastidious bacteria, or unexplained causes. We experienced false positive signal in a patient with hyperleukocytosis for the first time since the automated blood culture system was introduced in our hospital over 20 years ago. We present two case reports with literature review and describe the procedure for dealing with false-positive cases in our hospital

TRENDS IN THE MICROBIOLOGICAL SPECTRUM AND ANTIMICROBIAL RESISTANCE AMONG ICU PATIENTS DIAGNOSED WITH BACTEREMIA – A RETROSPECTIVE STUDY

Objectives: The objectives of this study were to determine the trends of microorganisms and their antimicrobial resistance pattern among ICU patients diagnosed with bacteremia. Methods: This retrospective study was conducted in the microbiology laboratory at a tertiary care teaching hospital from August 2021 to July 2022. A total of 2492 blood culture samples were collected from hospital ICUs from the patient with suspected septicemia. All samples were processed using the automated blood culture system BACT/ALERT 3D/60 for the recovery of pathogenic microorganisms, and antimicrobial susceptibility testing was performed using the automated VITEK 2 Compact system. A Chi-square test was done to assess the statistical significance of our results. Results: Out of 2492 blood culture samples, 296 (11.87%) were identified as culture positive, in which 252 (85.13%) were Gram-negative isolates, 38 (12.83%) were Gram-positive isolates, and 06 (2.02%) were other organisms (contaminants). Gram-negative isolates showed maximum sensitivity to colistin 205 (81.40%), and Gram-positive isolates showed maximum sensitivity to vancomycin 35 (92.10%). Conclusion: Early blood culture results could provide the basis for the appropriate use of antibiotics that can improve clinical prognosis and help in reducing mortality.

Bacterial Profile and Antimicrobial Susceptibility Pattern in Septicemia Suspected Children and Available Treatment Options

OBJECTIVES Septicaemia (blood poisoning) is one of the chief sources of global morbidity and mortality in pediatric patients and presents with multidrug and extensive drug resistance. This study aims to detect the major causative agents, antimicrobial susceptibility patterns and associated factors of bacteraemia among pediatric patients.METHODOLOGY This retrospective cross-sectional study was done at National Medical Center, Karachi microbiology laboratory. Clinical specimens consist of blood. Blood samples were processed in BACTEC's automated blood culture system, and positive samples were sub-cultured on blood, Mac-Conkey. Final identification was done by API 20E and API 20NE (Biomerieux) and confirmed by MicroScan (Beckman coulter)®. The antimicrobial susceptibility was performed by using Bauer– Kirby disk diffusion method.RESULTS A total of 395 pediatric patients were taken in the study. Out of these patients, 226 (57.2 %) were female. The children with age 1-4 years were highly affected. Almost 50% were handled in emergency and transferred for admission. 36.2% of patients were exposed to intravenous devices. 89 (22.5%) patients had a history of prolonged use of antibiotics. Most patients with pneumonia presented with septicemia as a complication, and were detected by Klebsiella pneumonia (35.4%), Acinetobacter bauminii (25.3%) and Pseudomonas aeruginosa (20.3%). CONCLUSION The study revealed that gram-negative organisms are the predominant causative organisms of septicaemia. Antibiotic resistance to Carbapenem is gradually increased in the case of Acinetobacter bauminii and Escherichia coli. These issues can be overcome by early detection of microorganisms and establishing antibiotic stewardship.

A Comparative Study of Conventional and Automated Blood Culture System in Adult Patients

Introduction: Blood culture is considered as the gold standard for the diagnosis of bloodstream infection. Conventional blood culture system is less sensitive and takes longer duration for the detection of bloodstream infections whereas automated blood culture system is more sensitive and rapid in detecting causative organisms of bloodstream infections. This prospective study was undertaken to compare the automated blood culture system with the conventional blood culture system for the identification of microbial pathogens in bloodstream infections. Method: This prospective study was done in Department of Microbiology, Silchar Medical College &amp; Hospital, Silchar for a period of 7 months from November 2021 to May 2022. Blood samples from the patients were inoculated into BD BACTEC Plus Aerobic culture vials for automated blood culture system and Brain Heart Infusion broth for conventional blood culture system. Positive bottles flagged by the automated machine were isolated and identified by doing routine subcultures on Blood agar and MacConkey agar and necessary biochemical tests. The conventional blood culture bottles were processed as per standard protocols. Result: Out of 123 samples, 21(17.09%) showed culture positivity by automated blood culture method and 15(12.19%) showed culture positivity by conventional blood culture method. The most common isolate was Staphylococcus aureus followed by Escherichia coli in automated method whereas the most common isolate in conventional method was Staphylococcus aureus followed by Klebsiella pneumoniae. Conclusion: This study concluded that automated blood culture method is more sensitive than conventional method and detects the presence of microorganisms rapidly causing bloodstream infections. Keywords: Bloodstream infection, Automated blood culture, Conventional blood culture

The Gram stain: Implication in blood culture reporting.

Bloodstream infections are life-threatening. They are responsible for prolonged hospital stays and high healthcare costs. Clinical microbiology has an essential role to play in its management. Direct Gram-stain reporting from positive blood culture bottles has been found helpful. We aimed to evaluate the use of the automated blood culture system in adjunct to the conventional Gram-stain technique, with a direct antimicrobial susceptibility test on the second day. Concordance was highly satisfactory.

Evaluation of the relevance of use of the BD-BACTEC®MycosisIC/F, BD-BACTEC®PlusAerobic/F, BD-BACTEC®Lytic/10 anaerobic/F and BD-BACTEC®PedsPlus/F culture bottle system for fungemia detection: A 4-year retrospective study at the Dijon university hospital, France.

Fungemia is a severe invasive fungal infection that combines rapid progression and a high mortality rate. This type of infection is a vital emergency, and early diagnosis is crucial. Currently, only the BD-BACTEC® Automated Blood Culture System (Becton Dickinson, New Jersey, USA) has a medium specifically dedicated to the detection of fungal agents: the BD-BACTEC®MycosisIC/F bottle. Thus, it is important to assess the performance of the different bottles offered by the BD-BACTEC® Automated Blood Culture System for the diagnosis of fungemia. The aim of this study was to evaluate the performance of the BD-BACTEC® MycosisIC/F culture medium in comparison to bacteriologic culture bottle media for the detection of fungemia in different clinical situations. This retrospective study was conducted over a period of 4 years at the Dijon University Hospital. Three hundred and thirty-one pairs of blood cultures (i.e. a BD-BACTEC® MycosisIC/F culture bottle associated with at least one bacteriologic culture media bottle) were included in this study. We showed that the BD-BACTEC® MycosisIC/F culture bottles performed significantly better (i.e. diagnostic advantage either because it was the only positive bottle of the pair or time to positive result was shorter) than the bacteriological culture bottles in 57.7% (191/331) of cases (p <0.01). Multivariate analysis revealed that BD-BACTEC®MycosisIC/F bottles had better diagnostic performance than BD-BACTEC®Bacteriologic bottles in the context of: (i) the initial versus follow-up diagnostic subgroup, (ii) venipuncture or arterial sampling versus other sampling methods, and (iii) detection of filamentous versus yeast fungi. We concluded that the use of BD-BACTEC® MycosisIC/F culture bottles is a relevant addition to media optimized for routine bacterial detection.

Brucellosis in pyrexia of unknown origin: Reminiscing the forgotten entity

PurposeBrucellosis is one of the substantial yet forgotten entity of pyrexia of unknown origin, transmitted via contact with animals or animal products. Despite being an important etiological agent of PUO, it is under-reported owing to its non-specific and protean clinical presentations. Thereby, the present study intended to describe clinical profile and outcome of patients of brucellosis from a tertiary care center in North India. MethodsThis was a retrospective study and included all the patients that were reported positive for Brucella in automated blood culture system (BACTEC) and identified using MALDI-TOF MS over a period of 6 years (2014–2020). ResultsA total of nine cases were reported positive for Brucella during the study period. Fever was noted to be the most common symptom present in all the patients (PUO), followed by fatigue. The patients were managed with monotherapy using doxycycline or combination of cotrimoxazole, rifampicin and doxycycline. All the patients responded well to treatment. ConclusionThe present study highlights the significance of automated blood culture system in conjunction with MALDI-TOF MS for early and reliable identification of Brucella. In the present study, all cultures were reported positive within five days of incubation in automated blood culture system, underlining the significance of using the same which lessens the turnaround time and increases the sensitivity. Owing to the protean manifestations and low sensitivity of the available tests, the clinician needs to have a high level of suspicion to precisely diagnose the illness to prevent undue delay in management.