Kirn T J, Mirrett S, Reller L B, Weinstein M P
Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
J Clin Microbiol. 2014 Mar;52(3):839-43. doi: 10.1128/JCM.03063-13. Epub 2013 Dec 26.
New blood culture media containing antibiotic-binding polymeric beads have been developed for the BacT/Alert (bioMérieux, Inc., Durham, NC) blood culture system. To assess the performance of these new media, we compared the new BacT/Alert aerobic medium (FA Plus) with resins to BacT/Alert FA medium with activated charcoal and the new BacT/Alert anaerobic medium (FN Plus) to BacT/Alert FN medium at 3 tertiary care medical centers. Study bottle pairs were inoculated with a target volume of 6 to 10 ml of blood from adults and incubated in the BacT/Alert 3D blood culture instrument. In the FA Plus versus FA comparison, there were 1,507 study pairs. Among 170 isolates causing true bloodstream infections (BSIs), significantly more Staphylococcus aureus (P<0.001) and total microorganisms (P<0.01) grew in the FA Plus bottle than in the FA bottle. Fewer coagulase-negative staphylococcal (CoNS) contaminants grew in the FA Plus bottle than in the FA bottle (10 versus 22; P=0.05). In addition, growth was detected earlier in the FA Plus bottle than in the FA bottle (P<0.001). In the FN Plus versus FN comparison, there were 2,386 study pairs. Among 201 isolates causing true BSIs, significantly more S. aureus (P<0.001), CoNS (P<0.005), and total microorganisms (P<0.001) grew in the FN Plus bottle than in the FN bottle. Also, significantly more CoNS contaminants grew in the FN Plus bottle than in the FN bottle (P<0.001). Overall, microorganisms were detected earlier in the FN Plus than in the FN bottle (P<0.001). Medical technologists at all 3 study sites preferred the new media for Gram stain interpretation. We conclude that the FA Plus and FN Plus media provide improved and earlier detection of microorganisms compared with the FA and FN media and are preferable for Gram stain interpretation as well.
已开发出含抗生素结合聚合物微珠的新型血培养培养基，用于BacT/Alert（生物梅里埃公司，北卡罗来纳州达勒姆）血培养系统。为评估这些新型培养基的性能，我们在3家三级医疗中心将含树脂的新型BacT/Alert需氧培养基（FA Plus）与含活性炭的BacT/Alert FA培养基，以及新型BacT/Alert厌氧培养基（FN Plus）与BacT/Alert FN培养基进行了比较。研究瓶对接种来自成人的6至10毫升目标血量，在BacT/Alert 3D血培养仪中孵育。在FA Plus与FA的比较中，有1507对研究瓶对。在170株导致真正血流感染（BSI）的分离株中，FA Plus瓶中生长的金黄色葡萄球菌（P<0.001）和总微生物（P<0.01）显著多于FA瓶。FA Plus瓶中生长的凝固酶阴性葡萄球菌（CoNS）污染物少于FA瓶（分别为10株和22株；P=0.05）。此外，FA Plus瓶中比FA瓶更早检测到生长（P<0.001）。在FN Plus与FN的比较中，有2386对研究瓶对。在201株导致真正BSI的分离株中，FN Plus瓶中生长的金黄色葡萄球菌（P<0.001）、CoNS（P<0.005）和总微生物（P<0.001）显著多于FN瓶。同样，FN Plus瓶中生长的CoNS污染物也显著多于FN瓶（P<0.001）。总体而言，FN Plus中比FN瓶更早检测到微生物（P<0.001）。所有3个研究地点的医学技术人员在革兰氏染色判读方面更倾向于新型培养基。我们得出结论，与FA和FN培养基相比，FA Plus和FN Plus培养基能更好且更早地检测到微生物，并且在革兰氏染色判读方面也更优。
