title: Detection of simulated candidemia by the BACTEC 9240 system with plus aerobic/F and anaerobic/F blood culture bottles.
abstract: We studied the ability of the BACTEC 9240 automated blood culture system to detect simulated candidemia, including both Candida albicans and non-albicans Candida species. Simulated blood cultures were produced using 50 Candida isolates and BACTEC Plus Aerobic/F and Anaerobic/F blood culture bottles. Ten milliliters of blood and a suspension of each isolate containing 1,000 CFU were introduced into each bottle and then incubated at 35 degrees C in the BACTEC 9240 system. The system detected growth in 56 of 100 bottles. Four isolates did not have growth detected in either bottle after 21 days of incubation, resulting in four missed episodes of candidemia. If the blood culture bottles had been incubated for 5 days, an additional episode of candidemia would have remained undetected. If the bottles had been incubated for only 3 days, another episode would have been missed, resulting in up to six missed episodes of candidemia (four Candida glabrata isolates, one C. albicans isolate, and one Candida rugosa isolate). Terminal subculture of bottles without detected growth recovered yeast in 93% (41 of 44) of the bottles, representing 41 false negatives. In bottles where growth was detected, the time to detection was approximately 24 h. However, the mean time to growth detection for C. glabrata isolates in anaerobic medium was 22.14 +/- 2.47 h, but it was 120.89 +/- 35.33 h in aerobic medium (P < 0.001). The BACTEC 9240 system detected growth of most Candida isolates; however, the delayed time to detection of C. glabrata is clinically significant. Given the high rate of false negatives, terminal subcultures may be helpful in certain situations.
authors.affiliation: Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA. Lynn.Horvath@amedd.army.mil
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Horvath
authors.forename: Duane R
authors.initials: DR
authors.lastname: Hospenthal
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.forename: David P
authors.initials: DP
authors.lastname: Dooley
mesh_terms: D000332:Aerobiosis; D000693:Anaerobiosis; D001769:Blood / Q000382:microbiology*; D002175:Candida / Q000145:classification / Q000254:growth & development* / Q000302:isolation & purification*; D002176:Candida albicans / Q000254:growth & development / Q000302:isolation & purification*; D002177:Candidiasis / Q000382:microbiology; D003470:Culture Media; D016469:Fungemia / Q000382:microbiology*; D006801:Humans; D008828:Microbiological Techniques; D011933:Reagent Kits, Diagnostic
chemical_list: D003470:Culture Media; D011933:Reagent Kits, Diagnostic