Performance of fungal blood cultures by using the Isolator collection system: is it cost-effective?

Author:

Morrell R M1,Wasilauskas B L1,Steffee C H1

Affiliation:

1. Department of Pathology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157, USA.

Abstract

Enhanced recovery of fungal isolates from blood by using the Isolator system has been reported previously. We examined bacterial and fungal blood cultures during a 14-month period to determine if this enhanced recovery required a separate fungal culture and to determine the differential utility between a fungal blood culture and a routine bacterial culture. During this period, 84 of 5,196 (1.6%) fungal blood cultures and 170 of 25,702 (0.6%) bacterial blood cultures were positive for yeast or filamentous fungi. Thirty-seven positive fungal cultures, simultaneously collected, had correspondingly positive bacterial cultures. An additional 15 positive fungal cultures yielded isolates that had either been previously recovered from a bacterial culture or were recovered from a bacterial culture collected within 48 h. Of the 32 unpaired fungal cultures remaining, 5 were Candida albicans whose unique isolation was believed to be the result of specimen sampling variance rather than any enhanced recovery characteristics of fungal culture methods. Examination of patient data relating to the 27 remaining isolates (24 patients episodes) showed that only five fungal blood cultures (0.096% of all collected) had any impact on patient therapy decisions, and one of these was judged to be the cause of unnecessary therapy. Our data suggest that separate fungal cultures of blood are not cost-effective for those laboratories using the Isolator for routine blood cultures and furthermore may not be cost-effective for laboratories using automated broth systems that are comparable to the Isolator in recovery of fungi.

Publisher

American Society for Microbiology

Subject

Microbiology (medical)

Reference9 articles.

1. Clinical evaluation of the Iysis-centrifugation blood culture system for the detection of fungemia and comparison with a conventional biphasic broth blood culture system;Bille J.;J. Clin. Microbiol.,1984

2. Fahle G. A. H. D. Engler and V. J. Gill. 1995. Comparison of the BacT/Alert and Isolator blood culture systems abstr. C-9 p. 2. In Abstracts of the 95th General Meeting of the American Society for Microbiology 1995. American Society for Microbiology Washington D.C.

3. Laboratory detection of fungemia;Geha D. J.;Clin. Lab. Med.,1994

4. Comparison of Du Pont Isolator and Roche Septi-Chek for detection of fungemia;Guerra-Romero L.;J. Clin. Microbiol.,1987

5. Microbiological and clinical evaluation of the Isolator Iysis-centrifugation blood culture tube;Henry N. K.;J. Clin. Microbiol.,1983

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