Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

6

Weeks in Review

2

Weeks to Publication
Indexed in KCI, KoreaMed, Synapse, DOAJ
Open Access, Peer Reviewed
pISSN 2288-0585 eISSN 2288-6850

Evaluation of BacT/Alert FAN Plus Bottles for the Culture of Peritoneal Dialysate

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2019 December, Volume 22, Issue 4, pages 90-95.

https://doi.org/10.5145/ACM.2019.22.4.90

Evaluation of BacT/Alert FAN Plus Bottles for the Culture of Peritoneal Dialysate

Min-Seung Park1, In Young Yoo1, On-Kyun Kang1, Jung Eun Lee2, Dae Joong Kim2, Hee Jae Huh1, Nam Yong Lee1
1Department of Laboratory Medicine and Genetics, 2Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Background: A major complication of peritoneal dialysis (PD) is peritonitis, and bacterial culture of PD effluent in a blood culture bottle is the preferred technique for diagnosis of peritonitis. In this study, we compared dialysate inoculation and culture using the BacT/AlerT Fastidious Antimicrobial Neutralization Plus blood culture bottles (FAN Plus; bioMérieux, France) to the conventional centrifugation culture method.

Methods: A total of 170 PD effluents were simultaneously processed by the conventional centrifugation culture method and by culture using FAN Plus media with two different inoculation procedures: inoculation after centrifugation and direct bedside inoculation.

Results: Of the 52 cultures that were positive on at least one of the culture methods, 27 samples were positive on conventional centrifugation. However, 46 samples showed growth following inoculation into the FAN Plus media after centrifugation, and 47 samples were positive on the direct FAN Plus inoculation method. Using the case definition for PD peritonitis to classify samples, sensitivity of the conventional method was 50.0% (95% CI, 33.7-66.3%), whereas the sensitivity of the FAN Plus media was 78.9% (95% CI, 62.2-89.9%) by inoculation after centrifugation and 86.8% (95% CI, 71.1-95.1%) by direct inoculation. Use of both inoculation methods with FAN Plus media resulted in 92.1% sensitivity (95% CI, 89.2-99.9%).

Conclusion: Culture using FAN Plus media demonstrated a superior bacterial recovery rate to the conventional centrifugation culture method. A combination of the two inoculation methods with FAN Plus media is recommended for the best diagnostic yield, while direct inoculation alone can be useful due to its simplicity and cost-effectiveness. (Ann Clin Microbiol 2019;22:90-95)

Keywords

BacT/AlerT 3D system, Centrifugation, Culture media, FAN Plus blood culture bottle, Peritoneal dialysis, Peritonitis