Volume of blood required to detect common neonatal pathogens☆,☆☆,★
Section snippets
Selection of microorganisms
Common neonatal pathogens, Escherichia coli (American Type Culture Collection strain 25922), Streptococcus agalactiae (group B streptococcus, ATCC strain 12386), Streptococcus agalactiae (type III, clinical isolate), Staphylococcus epidermidis (ATCC strain 35983), and Candida albicans (clinical isolate), were grown and suspended in sterile nonbacteriostatic normal saline solution.
Microbiologic quantification
Microorganisms were diluted to 108 colony-forming units per milliliter, with the turbidity measured with a
RESULTS
The automated instrument was 100% sensitive; organisms were detected on all positive plated subcultures. The instrument signaled four positive results (0.8%) that were subsequently negative on plated media. There was rare bacterial contamination. Contaminants were found in five culture bottles in the E. coli phase of the study and in two bottles of the C. albicans phase. In the case of every contaminant, the BacT/Alert device detected microbiologic growth.
The actual colony counts for the seeded
DISCUSSION
In adults, the volume of blood for culture is the most important factor influencing yield.18, 19, 20, 21, 22, 23 Numerous reports of adults indicate that more blood is better. Ilstrup and Washington20 found that the average yield for 30 ml blood is 61% greater than the yield for 10 ml blood. Mermel and Maki23 concluded that the yield of blood cultures in adults increases 3% per milliliter of blood cultured. Extrapolating data from the adult literature and applying it to children is problematic.
Acknowledgements
We thank Dr. David S. Louder for his assistance in the statistical analysis of data for this study.
References (28)
- et al.
Pediatric blood cultures
Clin Lab Med
(1994) - et al.
Automated blood culture systems
Clin Lab Med
(1994) - et al.
Sepsis syndrome and septic shock in pediatrics: current concepts of terminology, pathophysiology, and management
J Pediatr
(1993) - et al.
Effect of number of blood cultures and volume on detection of bacteremia in children
J Pediatr
(1996) - et al.
Diagnosis of neonatal bacteremia by a microblood culture technique
J Pediatr
(1977) - et al.
Recovery of clinically important microorganisms from the BacT/Alert blood culture system does not require testing for seven days
Diag Microbiol Infect Dis
(1993) - et al.
The importance of volume of blood cultured and the detection of bacteremia and fungemia
Diagn Microbiol Infect Dis
(1983) - et al.
Neonatal Escherichia coli septicemia: bacterial counts in blood
J Pediatr
(1974) - et al.
Quantitative blood cultures in childhood bacteremia
J Pediatr
(1978) - et al.
Quantitative aspects of septicemia
Clin Microbiol Rev
(1990)
Cumitech 1: blood cultures
Cumitech 1A: blood cultures
BacT/Alert: an automated colormetric microbial detection system
J Clin Microbiol
Application of new sepsis definitions to evaluate outcome of pediatric patients with severe sepsis
Pediatr Infect Dis J
Cited by (337)
Universal Digital High-Resolution Melt Analysis for the Diagnosis of Bacteremia
2024, Journal of Molecular DiagnosticsLate-Onset Sepsis
2023, Principles of NeonatologyNeonatal Bacterial Sepsis and Meningitis
2023, Avery's Diseases of the NewbornEfficacy and safety of switching from intravenous to oral antibiotics (amoxicillin–clavulanic acid) versus a full course of intravenous antibiotics in neonates with probable bacterial infection (RAIN): a multicentre, randomised, open-label, non-inferiority trial
2022, The Lancet Child and Adolescent HealthPivotal challenges in artificial intelligence and machine learning applications for neonatal care
2022, Seminars in Fetal and Neonatal MedicineInfections in the NICU: Neonatal sepsis
2022, Seminars in Pediatric Surgery
- ☆
From the Divisions of Neonatology and Pathology, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas
- ☆☆
Reprint requests: Robert L. Schelonka, CAPT, USAF MC, Department of Pediatrics, Wilford Hall Medical Center/PSP, 2200 Bergquist Dr., Suite 1, Lackland AFB, TX 78236-5300.
- ★
9/21/74224