Controlled evaluation of supplemented peptone and Bactec blood culture broths for the detection of bacteremia and fungemia.

Comparison of conventional blood culture media with newer formulations of Bactec media for radiometric detection are lacking. Therefore, we compared the yield and speed of detection of clinically important microorganisms with supplemented peptone broth (SPB) and Bactec aerobic (6B) and anaerobic (7C or 7D) broths in 7,627 blood samples from adult patients. Acridine orange stains from SPB, radiometric readings from Bactec, and routine subcultures from all bottles were done at the same time intervals. Bactec grew more facultative gram-positive bacteria (P less than 0.02), Bacteroides spp. (P less than 0.001), gram-negative anaerobes (P less than 0.001). The two-bottle Bactec system required less time to detect Staphylococcus aureus (P less than 0.001), facultative gram-positive bacteria (P less than 0.001), Escherichia coli (P less than 0.02), facultative gram-negative bacteria (P less than .001), and fungi (P less than 0.001). Overall, Bactec yielded 11% more microorganisms and detected bacteremia sooner in 18% of samples than did SPB. This advantage was not because of radiometric monitoring, since most positive Bactec bottles were detected macroscopically. SPB offered no advantage for any group of microorganisms. We conclude that Bactec 6B and 7C or 7D broths used as a unit are superior to a single bottle of SPB with an equal volume of blood for the detection of bacteremia and fungemia, and that Bactec's superiority is not due to the method of detection.

Duke Scholars

Author Lyman Barth Reller Pathology