Natale Alessandra, Oueslati Saoussen, Rochard Alice, Ombelet Sien, Lopez-Baez Daniel, Hardy Liselotte, Cunningham Jane, Franquesa Céline, Vandenberg Olivier, Ronat Jean-Baptiste, Naas Thierry
Médecins Sans Frontières, Operational Center Paris, 75019 Paris, France.
Team ReSIST, INSERM U1184, Université Paris Saclay, CEA, Inserm, Immunologie des Maladies Virales, Auto-Immunes, Hématologiques et Bactériennes (IMVA-HB/IDMIT), 92265 Fontenay-aux-Roses & Kremlin Bicêtre, France.
Diagnostics (Basel). 2023 Jan 31;13(3):523. doi: 10.3390/diagnostics13030523.
Culture media is fundamental in clinical bacteriology for the detection and isolation of bacterial pathogens. However, in-house media preparation could be challenging in low-resource settings. InTray cassettes (Biomed Diagnostics) could be a valid alternative as they are compact, ready-to-use media preparations. In this study, we evaluate the use of two InTray media as a subculture alternative for the diagnosis of bloodstream infections: the InTray Müller-Hinton (MH) chocolate and the InTray Colorex™ Screen. The InTray MH chocolate was evaluated in 2 steps: firstly, using simulated positive blood cultures (reference evaluation study), and secondly, using positive blood cultures from a routine clinical laboratory (clinical evaluation study). The Colorex Screen was tested using simulated poly-microbial blood cultures. The sensitivity and specificity of the InTray MH chocolate were respectively 99.2% and 90% in the reference evaluation study and 97.1% and 88.2% in the clinical evaluation study. The time to detection (TTD) was ≤20 h in most positive blood cultures (99.8% and 97% in the two studies, respectively). The InTray MH Chocolate agar showed good performance when used directly from clinical blood cultures for single bacterial infections. However, mixed flora is more challenging to interpret on this media than on Colorex™ Screen, even for an experienced microbiologist.
培养基在临床细菌学中对于检测和分离细菌病原体至关重要。然而，在资源匮乏的环境中自行制备培养基可能具有挑战性。InTray培养盒（Biomed Diagnostics公司）可能是一种有效的替代方案，因为它们是紧凑的即用型培养基制剂。在本研究中，我们评估了两种InTray培养基作为诊断血流感染的继代培养替代物的使用情况：InTray Müller-Hinton（MH）巧克力培养基和InTray Colorex™筛选培养基。InTray MH巧克力培养基分两步进行评估：首先，使用模拟阳性血培养物（参考评估研究），其次，使用来自常规临床实验室的阳性血培养物（临床评估研究）。Colorex筛选培养基使用模拟多微生物血培养物进行测试。在参考评估研究中，InTray MH巧克力培养基的敏感性和特异性分别为99.2%和90%，在临床评估研究中分别为97.1%和88.2%。在大多数阳性血培养物中（两项研究中分别为99.8%和97%），检测时间（TTD）≤20小时。当直接从临床血培养物用于单一细菌感染时，InTray MH巧克力琼脂表现出良好的性能。然而，即使对于经验丰富的微生物学家来说，在这种培养基上解读混合菌群比在Colorex™筛选培养基上更具挑战性。
