Effect of delayed entry on performance of the BACT/ALERT FAN PLUS bottles in the BACT/ALERT VIRTUO blood culture system
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ORIGINAL ARTICLE
Effect of delayed entry on performance of the BACT/ALERT FAN PLUS bottles in the BACT/ALERT VIRTUO blood culture system Mary Adamik 1 & Anne Hutchins 1
&
Jasmin Mangilit 1 & Betsy Katzin 1 & Heather Totty 1 & Parampal Deol 1
Received: 19 June 2020 / Accepted: 15 September 2020 # The Author(s) 2020
Abstract Delayed entry of patient blood culture samples into a microbial detection system is unavoidable at times, due to off-shift staffing or transporting samples to centralized laboratories. Pre-incubation time and temperature of blood culture bottles are the most critical factors impacting recovery and detection of microorganisms. A total of 1377 BACT/ALERT® (BTA) Fastidious Antimicrobial Neutralization (FAN® PLUS) bottles (FA PLUS, FN PLUS, and PF PLUS) were tested after delayed entry times of 24 and 36 h at 20–25 °C (room temperature, RT) prior to loading into the BACT/ALERT® VIRTUO® microbial detection system (VIRTUO). Clinically relevant organisms were inoculated into bottles with 5–84 colony forming units (CFU) per bottle, and human blood (0 to 10 mL), and then loaded into the VIRTUO. When bottles were loaded without delay, a mean time to detection (TTD) of 9.6 h was observed. For delayed bottles, the TTD reported by the VIRTUO was added to the 24-h and 36-h delay times and resulted in average time to results of 32.5 h and 42.5 h, respectively. The FAN PLUS bottles in conjunction with the VIRTUO produced acceptable results when delays up to 24 h at 20–25 °C occur in loading. Keywords Blood culture . BACT/ALERT® . VIRTUO® . Sepsis . Delayed entry . Pre-incubation
Introduction In 2017, the World Health Assembly (WHA) and World Health Organization (WHO) made sepsis a global health priority that causes approximately six million deaths worldwide each year [1]. The WHA resolved to improve the prevention, diagnosis, and management of sepsis. Increased mortality rates correlated with delays in diagnosis of blood stream infections (BSI) and subsequent delays in initiation of effective treatment [2]. Blood culture bottles continue to be the gold standard for isolating the infectious agent from a patient. Ideally, blood or sterile body fluids are inoculated directly into culture bottles at the patient’s bedside and then transported to a clinical microbiology laboratory without delay. However, some hospitals have microbiology labs that are closed or under-staffed during off-shift, weekends, and holidays, or, do not have the facilities or equipment to perform blood cultures in-house. Without an in-house laboratory, samples are
* Anne Hutchins [email protected] 1
bioMérieux, Inc., Durham, NC, USA
collected and transported by courier at scheduled times to a central microbiology laboratory. During transport, delays can occur due to courier schedules and there may be temperature variations due to storage temperature or refrigeration of the samples. Few studies have been conducted that investigate the effects of time between blood culture inoculation and loading of bottles onto a detection syst
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