Clinical Significance of BD Bactec FX Blood Culture Incubation Beyond 96 Hours (4 Days)
JOURNAL OF CLINICAL MICROBIOLOGY(2022)
摘要
Blood cultures (BC) for bacteria and yeast have traditionally been incubated for 5 days using modern instruments. Many organisms may grow sooner, and the need for the full 5-day incubation period has been questioned. This study evaluated the clinical significance of isolates recovered beyond 96 h. A retrospective chart review was conducted on all positive BC (+BC) performed via BD Bactec FX with >96 h of incubation from 5/2019 to 1/2022 at the UW Health University Hospital clinical microbiology laboratory. A total of 59,958 BC were performed; 6,031 (10%) were -BC. Of -BC, 104 (2%) demonstrated growth >96 h. The 104 cultures were from 89 patients and included 12 (12%) Staphylococcus aureus (1 MRSA), 9 (9%) yeast (8 Candida sp.), 8 (8%) Escherichia coil and 7 (7%) Enterococcus sp. (1 VRE) isolates. Fifty-six percent (n = 50) of the 89 +BC >96 h cases were clinically significant, and 26% (n = 13) resulted in antibiotic adjustments based on the +BC; 4 of these had previous positive cultures. Of the remaining 37 clinically significant +BC >96 h for which no antibiotic changes were made, 32 patients had previous positive cultures. The majority (98%) of BC bottles were positive before 96 h. For isolates that required >96 h, most (56%) were considered clinically significant, including S. aureus and E. coli cultures. Changes to antibiotic therapy were made in a minority (26%) of clinically significant cases. Based on these findings, under routine conditions, laboratories using BD Bactec FX should maintain a 120 h incubation period.
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关键词
blood culture, blood culture incubation, time to positivity, BD Bactec FX, clinical impact
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