BD BACTEC 9050 Blood Culture system

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BD BACTEC 9050Blood Culture system
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Clinical Importance of Blood Cultures

• The earliest possible identification of
  bloodstream infections allows for
• Prompt optimization of antimicrobial therapy
• Diminished need for additional diagnostic testing
• Decreased length of hospital stay
• Decreased healthcare costs
• Increased survival rates
• However due to its clinical importance, every
  hour of earlier detection is crucial Vigano et
  al, Diag. Micro. Inf.Dis.., 44 (2002)

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Introduction

• Rapid detection of bacteria fungi.
• Samples drawn from patients and injected
  directly into BACTEC culture vials.
• Vials entered into instrument as soon as
  possible for maximum performance efficiency.

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Principle of Test
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Media
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Media

• Standard Aerobic/F
• Enriched Soybean-Casein Digest broth.
• Added CO2
• Aerobic microorganisms (bacteria and yeasts)
• Allows for 10ml of blood.
• No resins

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Media

• Standard Anaerobic/F
• Prereduced enriched Soybean-Casein digest broth
• Added CO2
• Recovery of anaerobic organisms
• 10ml Blood volume
• No resins

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Media

• Peds Plus/F
• Aerobic bacteria and yeasts
• Resins for increased recovery
• Pediatric or immunocompromised patients
• 3 5ml blood volume

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Resin Media

• Non-ionic and cationic exchangers
• Neutralizes most antibiotics
• Helps to lyse blood cells so that intra-celllar
  organisms are set free
• Provide the organsims with growth-centres to
  enhance speed and recovery rate.

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Blood CollectionSpecimen identification
Label both vials with patient demographics
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VERY IMPORTANT
DO NOT WRITE ON THE BARCODE LABEL
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Identify the test request
Remove the tear-off bar code strip and stick it
on the test request form
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Preparation of the vials
Remove the flip-off cap and disinfect the septum
with 70 Isopropanol or Ethanol
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Selection of the puncture site
Apply the tourniquet and select the vein
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Decontaminate the puncture site
Disinfect circularly from the inside to the
outside with povidone/iodine for 60 seconds
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Blood volume and inoculation sequence

• Inoculation Volume
• Mark the desired volume on the vials label
  before inoculation
• Adults 8 10ml
• Peds 1 3ml
• Myco/F 3 5ml
• Inoculation sequence
• Aerobic
• Anaerobic

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Mixing and transportation of the vials
Gently tip over several times
Bring to the lab as soon as possible
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Delayed Vial Entry

• Plus Aerobic/F Plus Anaerobic/F Peds Plus/F and
  Lytic/10 Anaerobic/F media
• 20 hours pre incubation _at_ 35C
• 48 hours _at_ room temperature
• Standard Aerobic and Standard Anaerobic media
• 12 hours pre incubation _at_ 35C
• 48 hours _at_ room temperature

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Ease of Use
50 Vial capacity
Operator instructions
LCD and keypad
Volume adjustable alarm
Fixed barcode reader with easy alignment
Built in temperature compensation std
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Functions

• There are three main functions
• Vial loading
• Remove negatives
• Remove positives

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• Vials may be held in the instrument for 5 7
  days
• Positive cultures may be detected with in 24
  hours.
• All positive cultures must be sub cultured and
  gram stained.

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Notification of positive vials

• New positive indicator lamp on the front of the
  instrument flashes.
• An audible alarm sounds
• On the main status display, the station is
  displayed as a filled circle with a plus ()
  sign.
• On opening the door the following sign appears

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Automated vs Manual Blood cultureClinical study,
1442 blood culture sets. 16,4 of the samples
were positive.

• Cumulative Detection Rate ()

Time (hours)
Saleh, A.F. et al. 8th ECCMID 1997
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In summary

• The gold standard for definitive diagnosis of
  septicemia and fungemia.
• A simple, direct method which can be implemented
  quickly.
• Safer no venting and non invasive.
• DVE
• Faster time to detection.
• Storage at room temperature.
• No additional sample preparation or enrichment.

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Thank you!