Assessment of Adequate Blood Culture Incubation Time to Accentuate Clinically Relevant Results from Blood Culture Instrument and Media System in a Tertiary Care Hospital Lahore

Main Article Content

Mehwish Saba Aslam
Muhammad Abid Farooque
Irfan Malik
Aneela Khawaja
Namra Yunus
Ammarah Mehmmod

Abstract

Background: Bloodstream infections necessitate rapid identification and management. Automated blood culture systems have revolutionized diagnostic microbiology by expediting pathogen detection and enabling effective clinical interventions. This study assesses the optimal incubation period for blood cultures in a tertiary healthcare setting, aiming to enhance diagnostic accuracy and support antibiotic stewardship.


Objective: To evaluate the adequacy of incubation times in blood cultures for producing clinically significant results using an automated system in a tertiary care setting.


Methods: This cross-sectional descriptive study was conducted at the Microbiology Section of Combined Military Hospital, Lahore, from October 2022 to March 2023. All patient blood samples processed through the Bactec/Alert system were studied. Positive samples were cultured on Blood and MacConkey agar and incubated at 35 ± 2°C for 24 hours. Positivity rates, contamination, and patient demographics were analyzed using the Laboratory Information Management System.


Results: Of the 8,216 blood culture bottles processed, 490 (5.96%) were flagged as positive. Early detection within the first 24 hours was noted in 41.63% (n=204) of cases, with subsequent detections on the second day at 58.65% (n=258), the third day at 5.30% (n=26), and the fourth day at 0.20% (n=1). The isolated pathogens included gram-positive organisms (16.32%, n=80), gram-negative organisms (80.20%, n=393), and Candida spp. (3.46%, n=17).


Conclusion: Timely and effective blood culturing is crucial for the diagnostic confirmation of bacteremia, enabling appropriate pathogen identification and antimicrobial therapy. Shortening detection times can significantly impact clinical outcomes, reduce healthcare costs, and promote antimicrobial stewardship.

Article Details

How to Cite
Aslam, M. S., Farooque, M. A., Malik, I., Khawaja, A., Yunus, N., & Mehmmod, A. (2024). Assessment of Adequate Blood Culture Incubation Time to Accentuate Clinically Relevant Results from Blood Culture Instrument and Media System in a Tertiary Care Hospital Lahore. Journal of Health and Rehabilitation Research, 4(2), 934–938. https://doi.org/10.61919/jhrr.v4i2.931
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Articles
Author Biographies

Mehwish Saba Aslam, Combined Military Hospital Lahore Pakistan.

Combined Military Hospital Lahore Pakistan.

Muhammad Abid Farooque, Combined Military Hospital Lahore Pakistan.

Combined Military Hospital Lahore Pakistan.

Irfan Malik, Armed Forces Institute of Pathology Rawalpindi Pakistan.

Armed Forces Institute of Pathology Rawalpindi, Pakistan.

Aneela Khawaja, Combined Military Hospital Lahore Pakistan.

Combined Military Hospital Lahore, Pakistan.

Namra Yunus, Combined Military Hospital Lahore Pakistan.

Combined Military Hospital Lahore, Pakistan.

Ammarah Mehmmod, Combined Military Hospital Lahore Pakistan.

Combined Military Hospital Lahore, Pakistan.

References

Patel R, Patel N, Patel R. Assessment of Factors Influencing the Positivity of Blood Culture by BacT/ALERT® 3D Microbial Detection System: A Cross-sectional Observational Study. J Clin & Diagnos Res. 2022; 16(8). DOI: 10.7860/JCDR/2022/56676.16759

Mazzulli T, Ratkov D, Guglielmin K, Gandhi B, Remington R, Birch R, Zimmer L, Garner CD. Impact of Implementation of BacT/Alert Virtuo on Blood Culture Time to Positivity in Sepsis Patients. Microbiol Spect. 2023:e05003-22. https://doi.org/10.1128/spectrum.05003-22

Roberts T, Chandna A, Watthanaworawit W, Thaiprakong A, Soeng S, Simmalavong M, et al. Impact of delayed processing of positive blood cultures on organism detection: a prospective multi-centre study. BMC Infect Dis. 2022; 22(1):517. https://doi.org/10.1128/spectrum.05003-22

PADMAJA K, SUDHAHARAN S, VEMU L, TEJA VD. Early Identification and Antimicrobial Susceptibility Testing of Short versus Standard Incubated Blood Cultures from a Tertiary Care Centre in Southern India. J Clin & Diagnos Res. 2022; 16(2).

Halperin AV, del Castillo Polo JA, Cortes-Cuevas JL, Cardenas Isasi MJ, Ampuero Morisaki M, Birch R, et al. Impact of Automated Blood Culture Systems on the Management of Bloodstream Infections: Results from a Crossover Diagnostic Clinical Trial. Microbiol Spect. 2022;10(5):e0143622.

https://doi.org/10.1128/spectrum.01436-22

Papavarnavas NS, Brink AJ, Dlamini S, Wasserman S, Whitelaw A, Ntusi NA, et al. Practice update to optimise the performance and interpretation of blood cultures: 2022. South Afr Med J. 2022; 112(6):397-402.10.7196/SAMJ.2022.v112i6.16537

Truong TT, Mongkolrattanothai K, Flores II, Dien Bard J. Evaluation of the Performance and Clinical Impact of a Rapid Phenotypic Susceptibility Testing Method Directly from Positive Blood Culture at a Pediatric Hospital. J Clin. Microbiol. 2022; 60(8):e00122-22. https://doi.org/10.3390/pathogens12020212.

Kitaya S, Kanamori H, Baba H, Oshima K, Takei K, Seike I, et all. Clinical and epidemiological characteristics of persistent bacteremia: A decadal observational study. Pathogens. 2023; 12(2):212. https://doi.org/10.3390/pathogens12020212

Odutola A, Bottomley C, Zaman SA, Lindsay J, Shah M, Hossain I, et al. Staphylococcus aureus bacteremia in children of rural areas of The Gambia, 2008–2015. Emerg Infect Dis. 2019; 25(4):701. doi: 10.3201/eid2504.180935

Idrees S, Baig SN. Evaluation of blood culture samples for contamination and assessment of possible causes. J Microbiol Sci. 2022; 1(01):18-21.https://doi.org/10.38211/jms.2022.01.01.04

Legese MH, Asrat D, Aseffa A, Hasan B, Mihret A, Swedberg G. Molecular epidemiology of extended-spectrum beta-lactamase and AmpC producing Enterobacteriaceae among sepsis patients in Ethiopia: a prospective multicenter study. Antibio. 2022; 11(2):131.ood Culture at a Pediatric Hospital. Journal of Clinical Microbiology. 2022 Aug 17; 60(8):e00122-22. https://www.mdpi.com/openaccess

Ombelet S, Natale A, Ronat JB, Vandenberg O, Jacobs J, Hardy L. Considerations in evaluating equipment-free blood culture bottles: A short protocol for use in low-resource settings. Plos one. 2022; 17(4):e0267491. https://doi.org/10.38211/jms.2022.01.01.04

Grinberg S, Schubert S, Hochauf-Stange K, Dalpke AH, Narvaez Encalada M. Saving Time in ssson the Fast System. J Clin Microbiol. 2022; 60(5):e02533-21. https://doi.org/10.1128/jcm.02533-21

Odutola A, Bottomley C, Zaman SA, Lindsay J, Shah M, Hossain I, et al. Staphylococcus aureus bacteremia in children of rural areas of The Gambia, 2008–2015. Emer Infect Dis. 2019; 25(4):701. doi: 10.3201/eid2504.180935

Idrees S, Baig SN. Evaluation of blood culture samples for contamination and assessment of possible causes. J Microbiol Sci. 2022;1(01):18-21 https://doi.org/10.38211/jms.2022.01.01.04.

Berksoy E, Öncel EK, Bardak Ş, Demir Ş, Yılmaz SB, Demir G, et al. True Bacteremia or Contamination? Predictive Factors for Contamination in Blood Cultures Obtained in the Pediatric Emergency Room. DOI: 10.4274/eajem.galenos.2022.90582

Oldberg K, Rasmussen M. Enterococcus faecalis in blood cultures, A prospective study on the role of persistent bacteremia. Diagnos Microbiol Infect Dis. 2021; 101(1):115433. https://doi.org/10.1016/j.diagmicrobio.2021.115433

Oldberg K, Thorén R, Nilson B, Gilje P, Inghammar M, Rasmussen M. Short time to blood culture positivity in Enterococcus faecalis infective endocarditis. Euro J Clin Microbiol & Infect Dis. 2021;40: 1657-64. https://doi.org/10.1007/s10096-021-04210-9

Halperin AV, del Castillo Polo JA, Cortes-Cuevas JL, Cardenas Isasi MJ, Ampuero Morisaki M, Birch R, et al. Impact of Automated Blood Culture Systems on the Management of Bloodstream Infections: Results from a Crossover Diagnostic Clinical Trial. MicrobiolSpect.2022;10(5):e0143622.https://doi.org/10.1128/spectrum.01436-22-A

Iancu AV, Arbune M, Zaharia EA, Tutunaru D, Maftei NM, Peptine LD, Țocu G, Gurău G. Prevalence and Antibiotic Resistance of Enterococcus spp.: A Retrospective Study in Hospitals of Southeast Romania. Applied Sciences. 2023 Mar 17; 13(6):3866. https://doi.org/10.3390/app13063866.

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