scholarly journals Study of a novel method to assist in early reporting of sepsis from the microbiology laboratory

2010 ◽  
Vol 4 (12) ◽  
pp. 822-827 ◽  
Author(s):  
Purabi Barman ◽  
Sharmila Sengupta ◽  
Shefali Singh
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Turnaround Time ◽  
Culture Broth ◽  
Microbiology Laboratory ◽  
Biochemical Tests ◽  
Automated Method ◽  
Solid Media ◽  
Disk Diffusion Testing ◽  
Novel Method

Introduction: Microbiology laboratories must provide accurate blood culture reports with rapid turnaround time (TAT) to effectively manage patients with sepsis. In this study three methods are compared for reporting blood culture results: a manual method that included use of a serum separator tube (SST),   the conventional manual, and an automated method for identification and susceptibility (ID/AST). Methodology: Broth from positive blood culture bottles was added to an SST and then centrifuged. The pellet obtained was used to directly inoculate biochemical tests for identification and agar plates for AST on the first day of positivity. Biochemicals and AST plates were read the next day and final results reported on the second day at 24 hours. For conventional disk diffusion testing, the newly positive blood culture broth was also inoculated on solid media on the first day and incubated overnight. The next day AST by was performed as well as biochemical tests from pure colonies. These colonies were also used to inoculate panels for ID/AST using the automated MicroScan 40SI System. These results were recorded on the third day and results reported at 48 hours. Results: The study included 851 samples Out of 106 (12.4%) positive blood cultures, 102 were included in the study; Comparison of the 3 methods showed good correlation. Identification was correctly reported in 95 (93.1%) isolates. The overall AST error rate was 3.8%, Conclusions: The use of SST and direct from pellet inoculation reduced TAT for identification and AST results between 18 and 24 hours.

scholarly journals 649. Clinical Implementation of a Rapid Susceptibility Testing Procedure, Directly From a Positive Blood Culture Using the Vitek®2 System on Gram Negative Rods

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S383
Author(s):  
Charma Henry ◽  
Dustin Evans ◽  
Daniel Navas ◽  
Arleen Barker ◽  
Chonnapat Somyos ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Susceptibility Testing ◽  
Testing Procedure ◽  
Turnaround Time ◽  
National Average ◽  
Major Error ◽  
Clinical Implementation ◽  
Salmonella Spp ◽  
Gram Negative

Abstract Background The national average of identification and susceptibility for organisms isolated from positive blood culture to final susceptibility based on growth on solid media is 48 hours. The goal of this research was to prove that the Vitek®2 (bioMérieux, Inc.) system can provide an accurate and reliable susceptibility result directly from positive blood culture for Gram negative rods and reduce the turnaround time (TAT) from positive blood culture to the final susceptibility. Methods An FDA-modified validation procedure was performed on positive blood cultures directly from the bottle to the VITEK®2 System for susceptibility testing. The protocol tested and validated an aliquot of 50uL of blood directly from the positive bottle into 10 mL of saline (1:200). The solution was vortexed and 3mL were placed in the VITEK®2 test tube. This protocol was intended only for Gram negative rods using the AST-GN70, AST-GN81 & AST-GN801 cards. This protocol followed the CLSI M52 and M100 guidelines. Results 515 organisms from clinical blood culture samples from July 2018 to October 2019 were evaluated. Organisms included, but were not limited to: E. coli, K. pneumoniae, Enterobacter spp., and P. aeruginosa, Proteus spp., Salmonella spp., Acinetobacter spp., and S. maltophilia. There were 5,201 drug/bug combinations. AdventHealth Orlando achieved an essential agreement of 99.32% (n=5,166), minor error 0.74% (n=39) major error 0.02% (n=1) and very major error 0.49% (n=2). A 100% agreement was achieved on detection of ESBL, CRE, and MDR organisms. Conclusion Rapid direct blood culture protocol using the VITEK®2 System and the AST-GN cards is accurate, reliable and can be performed with less than 1 minute hands-on time. The protocol can be implemented in any laboratory at no additional costs or modification where the current VITEK®2 AST-GN panels are in use. This protocol was clinically implemented at AdventHealth Orlando on July 15, 2019. Compared with the national average of 72 hours, the TAT obtained during this study was 23 hours from positive blood culture to final susceptibility, a significant reduction of 25 hours. The authors encourage bioMérieux Inc. to evaluate and explore the opportunity to expand the use of the VITEK®2 system for this application with the appropriate clinical trial. Disclosures All Authors: No reported disclosures

To Study the Clinical Profile of Neonatal Sepsis and the Sensitivity of Various Markers of Sepsis Screen

2014 ◽  
Vol 1 (1) ◽  
pp. 19
Author(s):  
Sagar Sonawane ◽  
Milind Suryawanshi ◽  
Priyanka Patil ◽  
Ravindra Sonawane ◽  
M. K. Tolani
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
Gastric Bleeding ◽  
Automated Method ◽  
Feed Intolerance ◽  
Sepsis Screen ◽  
A Prospective Study

<strong>Objective:</strong> To study the clinical profile of Neonatal Sepsis &amp; the sensitivity of various markers of sepsis screen. <strong>Material &amp; Methods:</strong> This was a prospective study of neonates admitted to our NICU from January 2010 to October 2011 with diagnosis of neonatal sepsis or those who developed sepsis later on during their stay in NICU. All newborns diagnosed as a case of neonatal sepsis, based on clinical features with positive sepsis screen and/or positive blood culture, were included in our study. Blood Culture &amp; Sensitivity was done with conventional non–automated method using Herley’s Broth. <strong>Result:</strong> Common clinical manifestations of Neonatal Sepsis among the study group were Lethargy (96.36%), Tachypnea (92.73%), Refusal to suck/feeding difficulty (76.36%), Delayed CRT, Poor Pulses (74.55%), Sclerema (61.82%), Gastric Bleeding (45.45%) &amp; Feed Intolerance (45.45%). 46 babies had positive sepsis screen (sensitivity 84%), while 27 babies had a positive blood culture (sensitivity 49.09%).

scholarly journals Identification of Gram-negative bacilli directly from positive blood culture vials

2007 ◽  
Vol 56 (4) ◽  
pp. 475-479
Author(s):  
Siew Yong Ng ◽  
Lee Ling Kwang ◽  
Thean Yen Tan
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Clinical Management ◽  
Blood Cultures ◽  
Potential Saving ◽  
Biochemical Tests ◽  
Gram Negative ◽  
Genus Level ◽  
Direct Inoculation ◽  
Genus Identification

The provision of rapid results from positive blood cultures is important for the clinical management of septicaemia. This study tested the accuracy of direct inoculation of biochemical tests from positive blood culture vials for the identification of members of the Enterobacteriaceae and Acinetobacter species. A hundred and eighty-one samples were included in the study, with 25 % subsequently excluded as a result of mixed colonial growth. The study method successfully identified 133 (98 %) isolates from 136 vials to genus level and was technically simple to perform, requiring an additional 3 min for the processing of each positive vial. The results of this study demonstrate that a direct inoculation method provides acceptable genus identification of Gram-negative bacilli in positive blood culture vials, with a potential saving of 24 h compared with traditional methods.

scholarly journals Rapid identification of bacteria from positive blood culture bottles by MALDI-TOF MS following short-term incubation on solid media

2015 ◽  
Vol 64 (11) ◽  
pp. 1346-1352 ◽  
Author(s):  
Osman Altun ◽  
Silvia Botero-Kleiven ◽  
Sarah Carlsson ◽  
Måns Ullberg ◽  
Volkan Özenci
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Rapid Identification ◽  
Short Term ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Solid Media ◽  
Identification Of Bacteria ◽  
Tof Ms

scholarly journals Rapid and accurate direct antibiotic susceptibility testing of blood culture broths using MALDI Sepsityper combined with the BD Phoenix automated system

2014 ◽  
Vol 63 (12) ◽  
pp. 1590-1594 ◽  
Author(s):  
Briony Hazelton ◽  
Lee C. Thomas ◽  
Thomas Olma ◽  
Jen Kok ◽  
Matthew O’Sullivan ◽  
...  
Keyword(s):  
Blood Culture ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Turnaround Time ◽  
Automated System ◽  
Antibiotic Susceptibility Testing ◽  
Gram Negative ◽  
Cell Pellet ◽  
Novel Method ◽  
Susceptibility Tests

Antibiotic susceptibility testing with the BD Phoenix system on bacterial cell pellets generated from blood culture broths using the Bruker MALDI Sepsityper kit was evaluated. Seventy-six Gram-negative isolates, including 12 with defined multi-resistant phenotypes, had antibiotic susceptibility testing (AST) performed by Phoenix on the cell pellet in parallel with conventional methods. In total, 1414/1444 (97.9 %) of susceptibility tests were concordant, with only 1 (0.07 %) very major error. This novel method has the potential to reduce the turnaround time for AST results by up to a day for Gram-negative bacteraemias.

Processing of Positive Blood Cultures Using a Total Laboratory Automation System: Workflow and Clinical Validation

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S31-S32
Author(s):  
Kaitlin Mitchell ◽  
Abby Crozier ◽  
Carey-Ann Burnham ◽  
Melanie Yarbrough
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Culture Broth ◽  
Blood Cultures ◽  
Laboratory Automation ◽  
Clinical Testing ◽  
Gram Negative ◽  
Automated Processing ◽  
Total Laboratory Automation ◽  
Anaerobic Media

Abstract Automated systems for culture-based microbiology are in the early phase of implementation in clinical laboratories. Here, our objective was to evaluate the performance of the BD Kiestra Total Laboratory Automation (TLA) System for inoculation, incubation, and imaging of positive blood culture broth specimens. To optimize parameters for clinical testing, 56 clinical specimens were processed using both TLA and manual standard-of-care (SOC) methods. For TLA processing, 3 mL positive blood culture broth (35 VersaTREK: 19 aerobic, 16 anaerobic; 21 BD BACTEC: 15 aerobic, 6 anaerobic) was transferred to a no-additive vacutainer using a safety adapter and syringe. This aliquot was then placed on TLA for fully automated processing: 10 µL was inoculated to blood, chocolate, and MacConkey agar (Remel) and, for anaerobic bottles only, Brucella blood agar (Hardy Diagnostics). Kiestra cross-streak pattern 5 was optimal for obtaining isolated colonies and was superior to quadrant-streaking methods. Additional media types were added based on Gram stain results of the positive blood specimen: CandiSelect (Bio-Rad) and Sabouraud Dextrose (Remel) were added if yeast were identified, and Colistin Nalidixic Acid agar (Remel) for Gram stains with mixed Gram-positive and Gram-negative morphology. Plates were imaged at 6, 8, 10, 12, 18, 38, and 62 hours. Anaerobic media were placed by the system in a media stacker, incubated off-line, and then imaged on the TLA at 24, 48, and 72 hours. SOC cultures were evaluated after overnight incubation and on days 2 and 3. Organism identification was performed using MALDI-TOF MS (Bruker). Based on our evaluation, optimal parameters for clinical implementation of TLA were identified. Microbial growth was scant at 6 hours of incubation, but by 8 hours, small discrete colonies were observed for most aerobes. Thus, imaging parameters selected for routine clinical testing were 8, 18, and 38 hours for aerobic media and one image taken at 38 hours for anaerobic media. TLA and SOC culture results had 96% agreement (29 Gram positive, 12 Gram negative, 5 mixed, 6 yeast, 1 no growth). Two specimens with a second low-abundance bacterial population were observed on TLA that were not observed with SOC. Reproducibility of TLA was tested by processing 6 positive samples in triplicate and found to be 100%. There was no carryover or contamination noted between specimens processed simultaneously on TLA. To evaluate if implementation of TLA impacted epidemiology of positive blood cultures, we compared the 10 most common organisms recovered pre- and post-TLA implementation (August-November 2017 compared to August-November 2018). We found these organisms were not significantly impacted by TLA processing. In conclusion, automated processing of positive blood cultures improves laboratory workflows and facilitates faster workup at 8 hours of incubation. These results demonstrate that automation is a viable avenue for the processing of positive blood cultures.

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