Improved time-to-detection with the new formulation of BD BACTEC Plus Aerobic/F Culture Vials: a real-world evidence study.

Abstract

BD BACTEC Plus Aerobic/F Culture Vials were modified to reduce time-to-detection (TTD) of bacteria and yeast in blood specimens. Analytical testing involved seeded blood specimens in either predicate plus (N = 500) and modified plus (N = 500) media. Clinical testing used positive aerobic vial results from BD EpiCenter System Software for two periods: predicate plus (N = 1,075) and modified plus medium (N = 873). TTD was measured from the start of vial incubation to microorganism growth detection on BD BACTEC FX. Wilcoxon rank-sum and Chi-square (χ²) tests were used to compare TTD and 48-hour positivity. Modified plus reduced TTD by 2.6 hours (P < 0.001) in analytical testing and 2.9 hours (P < 0.05) in clinical testing. Significant TTD reductions were observed for E. coli, E. faecalis, S. epidermidis, and P. mirabilis. The incidence of late positives (detection after 48 hours) decreased from 10.5% to 6.9%. Modified plus media significantly reduces TTD and the number of late positives for a range of microorganisms.

Importance: Faster detection of infectious organisms can help improve patient prognosis. Recently, the formulation of aerobic culture vial media was modified for blood culture on the BD BACTEC instrument. The work presented here provides compelling evidence that the new aerobic media formulation improves time-to-detection for bloodstream infections. This has the potential to impact the healthcare treatment of millions of patients each year without requiring changes in clinical workflow. Faster time to detection can lead to faster organism identification and antimicrobial susceptibility testing (when appropriate). This report provides a comprehensive comparison of the novel media formulation with the predicate formulation for detecting multiple organism genera in both analytical and prospective clinical studies.