Automated Blood Culture System Research Articles

Validity of reducing blood culture incubation time for the BD BACTEC FX blood culture system considering microbiological and clinical aspects

IntroductionA blood culture (BC) test is vital for diagnosing bacteremia in clinical practice. Although incubation time varies among automated BC systems, 4–5 days is deemed to be sufficient time for the BD BACTEC FX blood culture system. This study compared the clinical and microbiological characteristics of true-positive BC samples on day 5 with those within 4 days to reduce missed true bacteremia cases. MethodsWe conducted a retrospective study of blood cultures from hospitalized patients between April 2020 and April 2023 at a tertiary care hospital in Japan. ResultsIn total, 12,342 BC sets were collected from 6,567 patients. Gram-positive bacilli other than Bacillus spp. and Corynebacterium spp., non-albicans Candida, and yeasts other than Candida spp. were detected more frequently in BC-positive patients on day 5 than in those within 4 days. The gastrointestinal tract was the portal of entry more frequently on day 5 than within 4 days (25 % vs. 4 %, p = 0.006). ConclusionA 4-day incubation period is sufficient for the BD BACTEC FX blood culture system under routine conditions. However, a 5-day incubation period may be warranted when low pathogenicity is suspected or the gastrointestinal tract is suspected as the portal of entry.

Estimating bacterial load in S. aureus and E. coli bacteremia using bacterial growth graph from the continuous monitoring blood culture system

BackgroundWe examined whether the time to positivity (TTP) and growth and detection plot graph (GDPG) created by the automated blood culture system can be used to determine the bacterial load in bacteremic patients and its potential association correlation with disease severity.MethodsKnown bacterial inocula were injected into the blood culture bottles. The GDPGs for the specific inocula were downloaded and plotted. A cohort of 30 consecutive clinical cultures positive for S. aureus and E. coli was identified. Bacterial load was determined by comparing the GDPG with the “standard” curves. Variables associated with disease severity were compared across 3 bacterial load categories (< 100, 100–1000, > 1000 CFU/mL).ResultsS. aureus growth was sensitive to the blood volume obtained whereas E. coli growth was less so. A 12-hour delay in sample transfer to the microbiology laboratory resulted in a decrease in TTP by 2–3 h. Mean TTP was 15 and 10 h for S. aureus and E. coli, respectively, which correlates with > 1000 CFU/mL and 500–1000 CFU/ml. For S. aureus, patients with a bacterial load > 100 CFU/mL had a higher mortality rate, (OR for death = 9.7, 95% CI 1.6–59, p = 0.01). Bacterial load > 1000 CFU/mL had an odds ratio of 6.4 (95% CI1.2-35, p = 0.03) to predict an endovascular source. For E. coli bacteremia, we did not find any correlations with disease severity.ConclusionGDPG retrieved from the automated blood culture system can be used to estimate bacterial load. S.aureus bacterial load, but not E.coli, was associated with clinical outcome.

Evaluation of BACTEC™ FX and BacT/Alert™ Automated Blood Culture Systems for Detection of Clinically Relevant Bacterial and Yeast Species

Background: Bloodstream infections (BSI) are a significant health concern, necessitating effective diagnostic tools. This study evaluates the performance of the BD Bactec FX system in comparison to the established BacT/Alert system, examining mean time till detection (TTD) across various blood culture bottles.Methods: The study involves 148 blood culture bottles, inoculated with representative bacterial ATCC strains (n= 15) and 04 yeast isolates. Parallel testing is conducted by seeding 10–30 colony-forming units (CFU) in duplicate in both BD Bactec FX and BacT/Alert systems. TTD is assessed across aerobic, anaerobic, and pediatric bottles for diverse microbial species.Results: All 148 bottles tested in parallel show positive signals in both systems. BD Bactec FX demonstrates significantly shorter TTD for adult-seeded cultures in aerobic and anaerobic bottles compared to BacT/Alert Similarly, pediatric bottles with BD Bactec FX exhibit a shorter TTD compared to BacT/Alert. The statistical significance of TTD, 95% confidence intervals (CI), and p-values is evident for Bactec FX aerobic, anaerobic, and pediatric bottles across tested organisms. Notable examples of faster TTD include; Bacteroides ovatus (16.6h by Bactec FX vs. 70.5h by Bact/Alert 3D), Stenotrophomonas maltophilia (33.7h vs. 72.5h), and Streptococcus pyogenes (8.1h vs. 11.9h).Conclusions: In conclusion, the study’s findings demonstrate that BD Bactec FX surpasses BacT/Alert in prompt microbial detection, showcasing potential for early identification of bacteremia and fungemia. Faster TTD implies the potential to initiate timely antimicrobial treatment, thereby reducing patient morbidity and mortality. However, exceptions in certain microbial species highlight the need for comprehensive clinical validation to establish the broad applicability of these findings.Keywords: Blood Culture System; Recovery Rate; Time to detection; Blood stream infection; BTA3D; Bactec FX

Clinical Findings, Bacterial Agents, and Antibiotic Resistance in Children with Spontaneous Peritonitis in Southern Iran: An Academic Tertiary Referral Center's Experience.

Spontaneous bacterial peritonitis (SBP) is a fatal complication of ascites fluid infection. The causes of SBP in children differ from those in adults, and these bacteria are frequently resistant to antibiotics. Therefore, this study investigated the clinical findings, bacterial etiology, and antimicrobial resistance in children with SBP. This study was conducted on all new pediatric ascites patients, who were admitted to the Department of Pediatric Gastroenterology, Namazi Hospital, affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from 2021 to 2022. Required data such as demographic information, and clinical information such as complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Gram staining, blood culture by Automated Blood Culture System (BACTEC), and antibiogram of ascites fluids by disc diffusion method were all collected. Finally, the data were statistically analyzed using SPSS Software (version 26). Besides, the t test, Fisher's exact, Mann-Whitney, and Chi square tests were used for data analysis. In all tests, P≤0.05 was considered statistically significant. The present study examined 62 children with ascites of which 18 (29%) had SBP. The median (IQR) age was 2.5 (8.1) years. Thirty-four (54.8%) of the participants were girls. Abdominal pain was the most common clinical manifestation in patients (54%), and there was a significant association between abdominal pain and SBP (P=0.02). In 12 positive ascites fluid cultures, coagulase-negative staphylococci had the highest frequency (25%), followed by Escherichia coli (16.7%). Third-generation cephalosporins had a 25% sensitivity in the total positive cultures. This sensitivity was 33.3% for Gram-negative cultures and 16.6% for Gram-positive cultures. Although third-generation cephalosporins are recommended as the primary antibiotic for the empirical treatment of SBP, the present study found high bacterial resistance. Finally, empirical therapy should be tailored to each region's bacterial resistance features.

Use of flow cytometry method to detect contaminations of platelet suspensions

In this study, it was aimed to investigate bacterial contamination in apheresis platelet suspensions (APS) by automated blood culture system and flow cytometry method (FCM).33 spiked APS each using 11 bacterial strains (5 standard strains, 6 clinical isolates), were prepared in three different dilutions (1–10, 10–50, 50-100 cfu/mL), incubated in two different temperatures (35–37 °C and 22–24 °C) and different incubation times (18–96 h) evaluated by FCM. This three different dilutions were also inoculated into special platelet culture bottles (BacT/ALERT® BPA) and loaded into the blood culture system. Additionally 80 APSs routinely prepared in the Transfusion Center were evaluated by both FCM and the blood culture system. Platelets were lysed by freeze-thaw method.All spiked samples were positive with BacT/ALERT® BPA in 12–18 h. In 96 h incubation at 22–24 °C, the presence of bacteria was detected by FCM in all other samples (31/33) except low dilutions (1–10 and 10–100 CFU/ml) of K.pneumoniae standard strain. In the 35–37 °C, the presence of bacteria was detected by FCM in all samples (33/33) after 48 h of incubation. In routine APS one sample detected as positive (Bacillus simplex) with BacT/ALERT® BPA and no positivity was detected by FCM.The freeze-thaw method, which we have optimized for the lysis of platelets, is very practical and can be easily applied. The BacT/ALERT® system has been found to be very sensitive in detecting bacterial contamination in PSs. Flow cytometry method has been found to be successful, fast, easy to use and low cost in detecting bacterial contamination in PSs.

Assessment of Adequate Blood Culture Incubation Time to Accentuate Clinically Relevant Results from Blood Culture Instrument and Media System in a Tertiary Care Hospital Lahore

Background: Bloodstream infections necessitate rapid identification and management. Automated blood culture systems have revolutionized diagnostic microbiology by expediting pathogen detection and enabling effective clinical interventions. This study assesses the optimal incubation period for blood cultures in a tertiary healthcare setting, aiming to enhance diagnostic accuracy and support antibiotic stewardship. Objective: To evaluate the adequacy of incubation times in blood cultures for producing clinically significant results using an automated system in a tertiary care setting. Methods: This cross-sectional descriptive study was conducted at the Microbiology Section of Combined Military Hospital, Lahore, from October 2022 to March 2023. All patient blood samples processed through the Bactec/Alert system were studied. Positive samples were cultured on Blood and MacConkey agar and incubated at 35 ± 2°C for 24 hours. Positivity rates, contamination, and patient demographics were analyzed using the Laboratory Information Management System. Results: Of the 8,216 blood culture bottles processed, 490 (5.96%) were flagged as positive. Early detection within the first 24 hours was noted in 41.63% (n=204) of cases, with subsequent detections on the second day at 58.65% (n=258), the third day at 5.30% (n=26), and the fourth day at 0.20% (n=1). The isolated pathogens included gram-positive organisms (16.32%, n=80), gram-negative organisms (80.20%, n=393), and Candida spp. (3.46%, n=17). Conclusion: Timely and effective blood culturing is crucial for the diagnostic confirmation of bacteremia, enabling appropriate pathogen identification and antimicrobial therapy. Shortening detection times can significantly impact clinical outcomes, reduce healthcare costs, and promote antimicrobial stewardship.

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 &amp; 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.

Associated Risk Factors and Clinical Outcomes of Bloodstream Infections among COVID-19 Intensive Care Unit Patients in a Tertiary Care Hospital.

The COVID-19 infection is an ongoing public health crisis causing millions of deaths worldwide. COVID-19 patients admitted to the intensive care unit (ICU) are more vulnerable to acquire secondary bloodstream infections (sBSIs) which cause a significant morbidity and mortality. Thus, we aim to assess the risk factors of sBSIs and outcomes in COVID-19 ICU patients. One hundred blood culture samples with growth (cases) and other 100 blood culture with no growth(controls) were collected.. All the demographic data, laboratory data and antimicrobial resistance pattern were analysed . Blood culture bottle received in the Microbiology laboratory were loaded into Automated blood culture system. Flagged bottles were processed for final identification by MALDI TOF and automated antibiotic susceptibility testing. Flagged bottles were processed for final identification by MALDI TOF and automated antibiotic susceptibility testing. Raised C-reactive protein (CRP) (P = 0.0035), interleukin-6 (P = 0.0404), mechanical ventilation (MV) (P = 0.024), prior antimicrobial exposure (P = 0.002), longer ICU stay with median 11 days (P = 0.022), and higher mortality rate (P = 0.001) were significantly associated with the BSI. A significant proportion of BSIs were Gram-negative bacteria (n = 115) such as Acinetobacter baumannii 38 (33%) and Klebsiella pneumoniae 30 (26%). Monomicrobial organisms in blood yielded a higher proportion in our study 72 (72%). The highest resistance for Acinetobacter species (50) was observed with ceftazidime 29 (96.6%) amikacin 48 (96%), meropenem 48 (96%), cefotaxime 47 (94%), ciprofloxacin 46 (92%), and netilmicin 46 (92%). K. pneumoniae was highly resistant to cefotaxime 29 (96.6%), ceftazidime 29 (96.6%), ciprofloxacin 22 (73.3%), and cefuroxime 21 (70%). Among Gram-positive organisms, Enterococcus species showed that a resistance for high-level gentamicin and penicillin was 66.6%. Raised CRP, need of MV, prior antimicrobial exposure, and longer ICU stay should alarm clinicians for BSI. Hence, our study highlights the associated risk factors for BSI and emphasizes adherence to hospital infection control policies and antibiotic stewardship program.

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 &amp; 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 &amp; Hospital, Faridabad.&#x0D; Material &amp; 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.&#x0D; 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.&#x0D; 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&amp;reg; 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

Objectives: 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. Materials 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. Immuno-compromised 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. Conclusions: 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 &amp; 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.