Real-world time to positivity of 2 widely used commercial blood culture systems in patients with severe manifestations of sepsis: An analysis of the FABLED study
Author
Butler-Laporte, G.Yansouni, C.P.
Paquette, K.
Lawandi, A.
Stabler, S.N.
Akhter, M.
Davidson, A.C.
Gavric, M.
Jinah, R.
Saeed, Z.
Demir, K.
Sangsari, S.
Huang, K.
Mahpour, A.
Shamatutu, C.
Caya, C.
Troquet, J.-M.
Clark, G.
Wong, T.
Lee, T.C.
Stenstrom, R.
Sweet, D.
Cheng, M.P.
Affiliation
Department of Pulmonary and Critical Care Medicine, University of Arizona College of MedicineIssue Date
2020
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Oxford University PressCitation
Butler-Laporte, G., Yansouni, C. P., Paquette, K., Lawandi, A., Stabler, S. N., Akhter, M., ... & Cheng, M. P. (2020, September). Real-word time-to-positivity of two widely used commercial blood culture systems in patients with severe manifestations of sepsis: an analysis of the FABLED study. In Open Forum Infectious Diseases.Journal
Open Forum Infectious DiseasesRights
Copyright © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
Background. Of all microbiological tests performed, blood cultures have the most impact on patient care. Timely results are essential, especially in the management of sepsis. While there are multiple available blood culture systems on the market, they have never been compared in a prospective study in a critically ill population. Methods. We performed an analysis of the FABLED study cohort to compare culture results and time to positivity (TTP) of 2 widely used blood culture systems: BacT/Alert and BACTEC. In this multisite prospective study, patients with severe manifestations of sepsis had cultures drawn before antibiotics using systematic enrollment criteria and blood drawing methodology allowing for minimization of pre-analytical biases. Results. We enrolled 315 patients; 144 had blood cultures (47 positive) with BacT/Alert and 171 with BACTEC (53 positive). Patients whose blood cultures were processed using the BacT/Alert system were younger (median, 64 vs 70 years; P = .003), had a higher proportion of HIV (9.03% vs 1.75%; P = .008) and a lower qSOFA (P = .003). There were no statistically significant differences in the most commonly identified bacterial species. TTP was shorter for BACTEC (median [interquartile range {IQR}], 12.5 [10-14] hours) compared with BacT/Alert (median [IQR], 17 [14-21] hours; P < .0001). Conclusions. In this large prospective multi-centre study comparing the two blood culture systems among patients with severe manifestations of sepsis, and using a rigorous pre-analytical methodology, the BACTEC system yielded positive culture results 4.5 hours earlier than BacT/Alert. These results apply to commonly isolated bacteria. However, our study design did not allow direct comparison of TTP for unusual pathogens nor of clinical sensitivity between systems. More research is needed to determine the clinical implications of this finding. © 2020 The Author(s).Note
Open access journalISSN
2328-8957Version
Final published versionae974a485f413a2113503eed53cd6c53
10.1093/ofid/ofaa371
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Except where otherwise noted, this item's license is described as Copyright © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/.