The protocols for catheter insertion, manipulation and HD at our center are given in the Supplementary material . In all patients with clinical features suggestive of CABSI (see definition below), paired blood cultures (10 mL each from the peripheral blood and venous catheter hub) were obtained under sterile conditions, inoculated in culture media (BACT/ALERT SA, bioMérieux, Durham, NC, USA) and immediately transported to the microbiology laboratory. Peripheral blood cultures were obtained from the median cubital vein (if symptoms occurred apart from an HD session) or from the dialysis circuit (if symptoms occurred during HD). Plasma and serum samples for total and differential white cell count and serum procalcitonin were also sent simultaneously. The empirical antibiotic policy for the management of CABSIs at our center is vancomycin 1 g intravenous (IV) stat and piperacillin/tazobactam 4.5 g IV stat followed by 2.25 g IV every 8 hours. The antibiotic regime was modified where indicated based on blood culture results. The NTHC was removed once a CABSI was confirmed. We did not attempt catheter salvage.
Bact alert sa
Manufactured by bioMérieux
Sourced in United States, Denmark
The BACT/ALERT SA is a fully automated blood culture system designed for the detection of bloodstream infections. It utilizes a colorimetric sensor technology to monitor microbial growth in blood culture bottles. The system automatically incubates and continuously monitors the samples, providing timely detection of positive results.
Automatically generated - may contain errors
4 protocols using bact alert sa
1
Diagnosis and Management of Catheter-Associated Bloodstream Infections
2
Defining Ventilator-Associated Pneumonia and Bloodstream Infections
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VAP was defined as new or changing chest X-ray infiltrate/s occurring more than 48 h after initiation of invasive mechanical ventilation, plus both of the following: (i) new onset of fever (body temperature ≥ 38 °C)/hypothermia (body temperature ≤ 35 °C) and/or leukocytosis (total peripheral white blood cell count ≥ 10,000 cells/µL)/leukopenia (total WBC count ≤ 4500 cells/µL)/ > 15% immature neutrophils; (ii) new onset of suctioned respiratory secretions and/or need for acute ventilator support system changes to enhance oxygenation [13 (link)].
Catheter-related bloodstream infection (CRBSI) was defined as the presence of bacteremia originating from an intravenous catheter. Microbiological samples were performed using BacT/ALERT SA (aerobic) and BacT/ALERT SN (anaerobic) bottles incubated in the BacT/Alert 3D blood culture instrument (bioMérieux, Ballerup, Denmark) [14 (link)].
Fungal infection was diagnosed as previously described [15 (link)].
Catheter-related bloodstream infection (CRBSI) was defined as the presence of bacteremia originating from an intravenous catheter. Microbiological samples were performed using BacT/ALERT SA (aerobic) and BacT/ALERT SN (anaerobic) bottles incubated in the BacT/Alert 3D blood culture instrument (bioMérieux, Ballerup, Denmark) [14 (link)].
Fungal infection was diagnosed as previously described [15 (link)].
3
Rapid Microbial Identification in Blood Cultures
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Example 4
In this study, a sample of positive culture medium was removed from seeded BacT/ALERT® SA (bioMérieux, Inc.) blood cultures bottles within a few minutes of the BacT/ALERT® Microbial Detection System (bioMérieux, Inc.) calling the culture positive. Culture media removed from sterile blood culture bottles at similar times served as negative controls. The culture media samples were placed in acrylic cuvettes and read in the Fluorolog 3 with a full EEM scan. Fluorescence and scattering data were normalized to age-matched negative controls, and then analyzed by General Discriminant Analysis (GDA).
Measurements taken for multiple data points from each sample tested were compared to a database of EEM and reflectance data from blood cultures of 77 known microorganism strains, representing 12 species, and the tested strains were classified based on the comparisons. The percentage of strains correctly identified to the “Group” classification level based on the number of data points collected is presented in
4
Peripheral vs. Catheter Blood Cultures
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In all patients with clinical features suggestive of CABSI (see below), paired blood cultures (10 ml each) were obtained from the peripheral blood and venous catheter hub under sterile precautions and inoculated in culture media (BACT/ALERT® SA, bioMérieux Inc, Durham, NC). Peripheral blood cultures were obtained from the median cubital vein or the dialysis circuit.
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