peptones and Sepsis

In vitro, 1.2% gelatin counteracts the inhibition of growth of bacterial species by sodium polyanetholsulfonate in blood culture media. Additionally, 1% yeast extract has been used to promote bacterial growth. We compared the performance of supplemented peptone broth and Trypticase soy broth, both of which contained sodium polyanetholsulfonate, gelatin and yeast extract. Trypticase soy broth with gelatin and yeast extract inhibited (p less than 0.001) and delayed growth, especially of gram-positive (p less than 0.01) and gram-negative (p less than 0.005) anaerobic bacteria. Although the recovery of organisms usually inhibited by sodium polyanetholsulfonate was similar in supplemented peptone and Trypticase soy broths, supplemented peptone broth clearly was superior in the recovery of other organisms commonly found in blood cultures.

Topics: Bacteria; Blood; Caseins; Culture Media; Fungi; Gelatin; Humans; Mycoses; Peptones; Protein Hydrolysates; Sepsis

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.

Topics: Bacteria; Costs and Cost Analysis; Culture Media; Fungi; Humans; Mycoses; Peptones; Sepsis

The Roche Septi-Chek biphasic blood culture system with tryptic soy broth was compared with a conventional blood culture bottle with supplemented peptone broth in 6,956 paired blood cultures from adult patients. Both systems were inoculated with equal volumes of blood (5 ml) and incubated aerobically (vented) for 2 weeks. More clinically important bacteria and fungi, including Staphylococcus aureus, S. epidermidis, Escherichia coli and other Enterobacteriaceae, Pseudomonas aeruginosa, and Candida albicans and C. tropicalis were recovered from the biphasic system (P less than 0.001). In contrast, more clinically important anaerobic bacteria (P less than 0.001) and Gardnerella vaginalis (P less than 0.05) were recovered in conventional supplemented peptone broth. Staphylococci (P less than 0.01), Enterobacteriaceae other than E. coli (P less than 0.05), and fungi (P less than 0.001) were detected 1 or more days earlier in the biphasic system, whereas streptococci (P less than 0.001) were detected earlier in the conventional bottle. The overall superiority of the agar slide blood culture system compared with conventional blood culture bottles was confirmed by this evaluation. For optimal detection of anaerobic bacteremia, however, the agar slide bottle should be paired with an anaerobic bottle.

Topics: Agar; Bacteria; Blood; Culture Media; Fungi; Humans; Peptones; Sepsis

The value of hypertonic media in the detection of bacteremia and fungemia is controversial, since prior clinical trials have yielded conflicting results with different media. Earlier, we showed that the addition of 10% sucrose to supplemented peptone broth at a 1:10 ratio of blood to broth yielded better recovery of Staphylococcus epidermidis, the Enterobacteriaceae, Pseudomonas aeruginosa, and yeasts. To evaluate the effect of 10% sucrose on blood cultured at a 1:5 ratio, we compared the yield and speed of detection of clinically important microorganisms from adult patients in 5,839 blood samples cultured in supplemented peptone broth with 0.03% sodium polyanetholesulfonate with and without 10% sucrose. The atmosphere of incubation (open venting units), 1:5 ratio of blood to broth, and methods of processing were the same for both bottles. Recovery of facultative gram-positive (P less than 0.02) and gram-negative (P less than 0.02) bacteria was improved, but the recovery of anaerobic gram-negative bacteria was both reduced (P less than 0.01) and delayed (P less than 0.02) by sucrose. The total yield of microorganisms including fungi, however, was increased with sucrose. The effect of sucrose on blood cultures appears to depend on the ratio of blood to broth as well as on the medium used and strains of microorganisms encountered.

Topics: Bacteria; Blood; Culture Media; Evaluation Studies as Topic; Fungi; Hypertonic Solutions; Mycoses; Peptones; Sepsis; Sucrose

To evaluate the role of atmosphere of incubation in the detection of clinically important bacteremia and fungemia in adults, we compared the yield of microorganisms from 10,541 paired 5-ml samples of blood incubated aerobically and anaerobically. The medium, supplemented peptone broth (SPB) with 0.03% sodium polyanetholesulfonate, and the ratio of blood to broth (1:10) were the same for all cultures. Only cultures with adequate blood samples (greater than or equal to 80% of stated volume) were compared statistically. More fungi (P less than 10(-7) ) grew in continuously vented bottles of SPB. Aerobic incubation also favored (P less than 0.01) isolation of Neisseria gonorrhoeae and Eubacterium; more than 80% of these bacterial organisms were detected only in vented bottles. Anaerobic incubation (plugged venting units) did not significantly favor the isolation of any genus of microorganisms, although an estimated 11% more Bacteroidaceae grew in the unvented bottle of SPB. By comparison of our data with published results for other media, we conclude that the need for both aerobic and anaerobic incubation of blood cultures is dependent upon the medium used and the microorganisms likely to be encountered. Vented incubation of blood cultured in SPB is crucial for detection of fungi and some bacteria. Routine use of an unvented bottle of SPB may not be worthwhile for patients in whom Bacteroidaceae cause bacteremia infrequently. However, when Bacteroidaceae are suspected as the cause of sepsis, use of an unvented bottle of SPB is prudent.

Topics: Bacteria; Bacteroidaceae; Culture Media; Eubacterium; Fungi; Microbiological Techniques; Mycoses; Peptones; Sepsis

Because the value of hypertonic media in detection of bacteremia and fungemia is controversial, we evaluated supplemented peptone broth (SPB) with 0.03% sodium polyanetholsulfonate with and without 10% sucrose in 5,439 paired blood cultures from adult patients. The aerobic atmosphere, 1:10 ratio of blood to broth, and methods for processing blood cultures were identical. Only cultures with adequate blood samples (greater than or equal to 4 ml) were compared statistically. More clinically important bacteria were recovered from SPB with sucrose (P less than or equal to 0.001), including Staphylococcus epidermidis, Enterobacteriaceae, and Bacteroidaceae. However, only one of nine isolates of Neisseria gonorrhoeae grew in SPB with sucrose. Staphylococci (P less than 0.001), Enterobacteriaceae (P less than 0.01), Pseudomonas aeruginosa (P less than 0.01), and yeasts (P less than 0.05) were detected 1 or more days earlier in SPB with sucrose. The effect of sucrose on blood cultures appears to be medium dependent, based on comparisons of our results with those of published reports.

Topics: Bacteria; Culture Media; Fungi; Humans; Hypertonic Solutions; Mycoses; Penicillins; Peptones; Sepsis; Sucrose

A comparison of three different commercial media was made to assess their recovery of anaerobic organisms from the blood stream. The three media used were the 50-ml brain heart infusion broth with added CO2 (Pfizer), the 50-ml Thiol broth with added CO2 (Difco), and the 50-ml prereduced, supplemented peptone broth in a Vacutainer tube with added CO2 (Becton-Dickinson). During a period of 17 consecutive months, 12,216 specimens of blood were processed with each broth. Aerobic or anaerobic bacteria were recovered from 913 specimens (7%). Seventy-four specimens (8%) of the total positive cultures contained anaerobic organisms. When potential contaminants were removed from the totals, 7% of the positive cultures contained anaerobic organisms and 7% of the patients with positive cultures had bacteremia with anaerobic bacteria. Of the three commercial blood culture media studied, the prereduced, supplemented peptone broth recovered more anaerobic organisms than did either the brain heart infusion or Thiol broths.

Topics: Anaerobiosis; Bacteria; Blood; Carbon Dioxide; Culture Media; Diagnosis, Differential; Evaluation Studies as Topic; Humans; Peptones; Sepsis; Species Specificity

Two liquid blood culture media, Tryptic soy broth (TSB) and Thiol broth, containing sodium polyanetholsulfonate were compared in 8,654 cultures. Pseudomonas and Corynebacterium (including Propionibacterium) were isolated significantly more frequently (P < 0.001) from TSB than from Thiol. Escherichia coli, Haemophilus, and Bacteroidaceae were isolated more frequently in TSB; however, the differences were not statistically significant. In no instance was Thiol superior to TSB in detecting bacteremia. In an additional 2,977 cultures, aerobic and anaerobic Vacutainer culture tubes with supplemented peptone broth were inoculated in parallel with TSB and Thiol. Significantly greater rates of detection (P < 0.01) in TSB or Thiol were noted with Pseudomonas, E. coli, Enterobacter, viridans, and group A streptococci, Bacteroidaceae, and staphylococci.

Topics: Aerobiosis; Alkanesulfonates; Anaerobiosis; Anisoles; Anticoagulants; Bacteria; Bacteriological Techniques; Culture Media; Diagnosis, Differential; Glycine max; Humans; Peptones; Polymers; Sepsis; Species Specificity; Sulfhydryl Compounds; Time Factors; Trypsin