Positive Bactec resin cultures do not influence antimicrobial selection.
We performed a retrospective evaluation of Bactec resin blood cultures, submitted to the clinical laboratories of the University of Manitoba teaching hospitals, to determine the impact positive cultures might have on the selection of antimicrobial therapy. Of the 2919 resin cultures submitted in 1987, 151 were positive, with 161 separate isolates. Of these cultures, 13 were reported after the death of the patient and 8 could not be adequately assessed because of insufficient clinical information. Four positive cultures were obtained from patients not receiving antimicrobial therapy. Forty-four cultures (53 isolates) from 37 patients were judged to be contaminants. Each of the remaining 82 clinically significant positive cultures were monomicrobial. Isolates from 34 cultures were resistant to the antibiotics being administered and might have been expected to grow in nonresin blood cultures. Forty-eight isolates from 18 patients were susceptible to the antibiotic(s) being administered at the time the culture was drawn. In none of these patients did the positive result lead to a change in the choice of antimicrobial therapy. In only one case was there an increase in antibiotic dosage. It appears that positive Bactec resin blood cultures do not have a significant impact on antimicrobial selection, and routine use may not be justified.
Jessamine
P G
PG
Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
Hoban
D J
DJ
Forward
K R
KR
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D004352:Drug Resistance, Microbial; D006801:Humans; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents