title: Blood Culture Bottle and Standard Culture Bottle Methods for Detection of Bacterial Pathogens in Parapneumonic Pleural Effusion.
abstract: BACKGROUND
  Bacterial parapneumonic pleural effusions (PPEs) have high morbidity. The accurate identification of pathogens is vital for initiating the appropriate treatment. A previous study suggested that the use of blood culture bottles might improve the bacterial yield in PPEs.
  
  
  OBJECTIVE
  The aim of this study was to compare the culture positivity rate by the blood culture bottles and the standard culture bottles in bacterial PPEs.
  
  
  METHODS
  Patients diagnosed with PPEs at the Khon Kaen Hospital, Khon Kaen, Thailand, which is an endemic area of melioidosis, were enrolled consecutively and prospectively. The study period was from June first, 2012 to December 31st, 2013. The inclusion criteria were adult patients aged > 18 years, with exudative, neutrophilic parapneumonic effusion. Of the pleural fluid samples, 5 mL from all the eligible patients were collected in both blood culture bottles and the standard culture bottles. Patient baseline characteristics, laboratory results, and culture results were collected and analyzed.
  
  
  RESULTS
  During the study period, 129 patients met the study criteria. The bacteria-positive rate of pleural fluid culture using the standard culture bottle was 14.0%, whereas the positive rate using blood culture bottles was 24.0% (P < 0.001).
  
  
  CONCLUSIONS
  The blood culture bottle method is more effective than the standard culture bottle method for the detection of bacterial pathogens in PPE.
authors.affiliation: Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand.
authors.forename: Surapan
authors.initials: S
authors.lastname: Charoentunyarak
authors.affiliation: Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand.
authors.forename: Sarassawan
authors.initials: S
authors.lastname: Kananuraks
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Jarin
authors.initials: J
authors.lastname: Chindaprasirt
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Panita
authors.initials: P
authors.lastname: Limpawattana
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ; Research Center in Back, Neck Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth
keywords: Culture; Diagnosis; Efficacy; Parapneumonic Pleural Effusion