Magallon Arnaud, Basmaciyan Louise, Chapuis Angélique, Valot Stéphane, Sautour Marc, Bador Julien, Dalle Frédéric
Department of Bacteriology, University Hospital of Dijon, BP 37013, 21070 Dijon CEDEX, France; UMR/CNRS 6249 Chrono-environnement, University of Bourgogne-Franche-Comté, Besançon, France.
Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-universitaire, 2 rue A. Ducoudray, BP 37013, 21070 Dijon Cedex, France; UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, 21078 Dijon, cedex, France.
J Mycol Med. 2022 Nov;32(4):101295. doi: 10.1016/j.mycmed.2022.101295. Epub 2022 May 5.
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.
真菌血症是一种严重的侵袭性真菌感染，具有进展迅速和死亡率高的特点。这类感染是极为重要的急症，早期诊断至关重要。目前，只有BD - BACTEC®自动血培养系统（美国新泽西州的贝克顿·迪金森公司）有一种专门用于检测真菌病原体的培养基：BD - BACTEC®MycosisIC/F瓶。
因此，评估BD - BACTEC®自动血培养系统提供的不同培养瓶对真菌血症诊断的性能很重要。
本研究的目的是比较BD - BACTEC®MycosisIC/F培养基与细菌培养瓶培养基在不同临床情况下检测真菌血症的性能。
这项回顾性研究在第戎大学医院进行了4年。本研究纳入了331对血培养（即一个BD - BACTEC®MycosisIC/F培养瓶与至少一个细菌培养瓶培养基配对）。
我们发现，在57.7%（191/331）的病例中，BD - BACTEC®MycosisIC/F培养瓶的表现明显优于细菌培养瓶（即诊断优势在于它是配对中唯一呈阳性的培养瓶，或者阳性结果出现时间更短）（p<0.01）。多变量分析显示，在以下情况下，BD - BACTEC®MycosisIC/F瓶比BD - BACTEC®细菌培养瓶具有更好的诊断性能：（i）初始诊断与随访诊断亚组；（ii）静脉穿刺或动脉采样与其他采样方法；（iii）丝状真菌与酵母真菌的检测。
我们得出结论，BD - BACTEC®MycosisIC/F培养瓶的使用是对常规细菌检测优化培养基的一项重要补充。
