Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
St Paul's Hospital, Providence Health Care, University of British Columbia, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Clin Microbiol Infect. 2018 Sep;24(9):992-996. doi: 10.1016/j.cmi.2017.12.011. Epub 2017 Dec 20.
Continuous monitoring blood culture systems are commonly used for sterile body fluid cultures. In this multicentre study, we evaluated the performance of the new-generation BacT/Alert Virtuo system compared to the BacT/Alert 3D and conventional culture for the recovery of microorganisms from sterile body fluids.
Peritoneal, cerebrospinal, pericardial, pleural and synovial fluids from adult patients submitted for culture were collected from three different centres. Specimens were inoculated into two bottles of the same bottle type (SA, SN, FA Plus or FN Plus) in equal volumes for simultaneous incubation in the Virtuo and 3D instruments. Each specimen was also Gram stained and seeded to solid media.
A total of 811 specimens were inoculated to 1257 bottle pairs. The Virtuo and 3D showed equivalent recovery of clinically significant microorganisms (127/155, 81.9%, vs. 126/155, 81.3%, respectively). Solid media cultures recovered fewer pathogens than either continuous monitoring system (95/155, 61.3%, p <0.001), including significantly fewer Enterobacteriaceae and enterococci. The Virtuo was significantly faster than the 3D in median time to detection of isolates from the same specimen (12.5 (range, 2.8-101.5) hours vs. 15.5 (range, 4.3-78.5) hours, p <0.001). Direct specimen Gram stain detected the eventual pathogen in 30 (26.1%) of 115 significant positive specimens.
The BacT/Alert Virtuo system was equivalent to the 3D system in organism recovery from sterile body fluid culture but showed faster detection of growth as a result of design enhancements.
连续监测血培养系统常用于无菌体液培养。在这项多中心研究中,我们评估了新一代 BacT/Alert Virtuo 系统与 BacT/Alert 3D 系统和传统培养方法相比,从无菌体液中回收微生物的性能。
从三个不同的中心收集成人患者送检的腹膜、脑脊液、心包液、胸腔液和滑液。将标本等量接种到两种相同瓶型(SA、SN、FA Plus 或 FN Plus)的两个瓶中,同时在 Virtuo 和 3D 仪器中孵育。每个标本还进行革兰氏染色并接种到固体培养基上。
共接种 811 份标本至 1257 对瓶。Virtuo 和 3D 系统对临床有意义的微生物的回收率相当(127/155,81.9%,与 126/155,81.3%)。固体培养基培养物回收的病原体少于任何一种连续监测系统(95/155,61.3%,p<0.001),包括显著更少的肠杆菌科和肠球菌。Virtuo 从同一标本中检测到分离株的中位时间明显快于 3D(12.5(范围,2.8-101.5)小时与 15.5(范围,4.3-78.5)小时,p<0.001)。直接标本革兰氏染色在 30 份(26.1%)有意义的阳性标本中检测到最终病原体。
BacT/Alert Virtuo 系统与 3D 系统在从无菌体液培养中回收微生物方面相当,但由于设计改进,更快地检测到生长。