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10 protocols using bactec peds plus f

1

Standardized Clinical Laboratory Practices

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The clinical laboratory of CRUN is situated on the same compound as CMA. Laboratory practices have been standardized using Standard Operational Procedures (SOPs) and a quality management system according to Good Clinical Laboratory Practices principles is implemented.
Upon inclusion venous blood was sampled for malaria microscopy, full blood count (Sysmex XS1000i (Sysmex Corporation, Kobe, Japan)) and blood cultures (1–3 ml pediatric culture bottle (BD BACTEC Peds PlusTM /F, (Becton Dickinson and Company, Sparks, Maryland, USA)) as previously described [11 (link)]. Malaria was diagnosed by microscopy [12 ] and, at HC Nazoanga, also by rapid diagnostic test (RDT, SD Bioline Antigene Pf (Standard Diagnostics, Hagal-Dong, Korea)).
Samples from CMA were transported to CRUN within 15 minutes after collection. For HC Nazoanga, samples were stored and transported to CRUN by car (ambient temperature for blood cultures, 2–8°C for EDTA-anticoagulated blood) at the end of each day and transport time was recorded. The quality indicators are reported in S1 Appendix.
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2

Blood Culture Protocol for Bacteremia

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bBSI were diagnosed on site by collecting 1–3 ml of venous blood into pediatric blood culture bottles (BD BACTEC Peds PlusTM/F, Becton Dickinson and Company, Maryland, USA), which were incubated for 5 days in a BACTEC 9050 incubator (Becton Dickinson). Positive blood cultures were Gram stained, sub-cultured on Eosin-Methylene blue (EMB) agar and 5% sheep blood agar, and incubated at 35–37°C for 24 hours in respectively atmospheric and 5% CO2 environments. Bacterial isolates were identified to the species level by standard biochemical methods. EDTA blood samples were used for the diagnosis of malaria and the left-over blood was stored at -80°C for maximum one year and shipped frozen to the Institute of Tropical Medicine Antwerp (Belgium) for metagenomics analysis. Quality indicators used for monitoring of blood culture performance included blood volume sampled, proportion of contaminants and proportions of clinically significant bacteria recovered. In addition, pathogens were confirmed at the Institute of Tropical Medicine Antwerp for identification and antibiotic susceptibility testing [14 (link)].
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3

Rapid Polymicrobial Blood Culture Analysis

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Blood samples were drawn from patients recovered at the Cisanello Hospital of Pisa (Pisa, Italy). Blood cultures were processed at the Microbiology Unit of the Azienda Ospedaliero-Universitaria Pisana (Pisa, Italy). Samples were inoculated in both aerobic and anaerobic BC bottles (BACTEC Plus/F Aerobic, BACTEC Plus/F Anaerobic, BACTEC Peds Plus/F), and BCs were incubated in the BD BACTEC FX system (Becton Dickinson and Company; Milano, Italia) at 35 +/− 1.5 °C for up to 5 days. From each patient, only the first BC resulting polymicrobial after Gram staining was included in the present study. These included: BCs positive for both Gram-positive and Gram-negative bacteria; BCs containing Gram-positive cocci both in clusters (staphylococci) and in chains (streptococci/enterococci), and BCs in which both Gram-positive and/or Gram-negative bacteria and yeast were detected.
Each BC was analysed using both the routine method and the rapid method established in the present study.
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4

Bloodstream Infections Surveillance in Ghana

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Blood cultures were collected as part of hospital surveillance studies for bloodstream infections conducted between September 2007 and April 2015 at the Inpatient Department of Agogo Presbyterian Hospital and the Outpatient Department of St Michael’s Hospital, Pramso, both located in the Ashanti Region in central Ghana [10 (link),20 (link),23 (link),24 (link)]. All children ≥30 days and ≤15 years of age presenting with either a temperature of ≥37.5°C or reported fever within the past 72 hours were enrolled in the study. One to three milliliters of blood was taken from each child following local antisepsis protocols and inoculated into a paediatric blood culture bottle (BACTEC Peds Plus/F, Becton Dickinson) and processed using a BACTEC 9050 blood culture system (Becton Dickinson). During 2010, recruitment took place and blood cultures were performed on the adult ward of the Agogo Presbyterian Hospital.
Both local and imported poultry meat was purchased between May to December 2015 from retailers and open markets within Kumasi, the capital of the Ashanti region. 15g of each meat sample was immediately placed in sterile homogeniser bags and transported refrigerated to the laboratory.
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5

Comprehensive CSF and Blood Analysis in AE

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The CSF of all patients was collected when virus infection-like symptoms (T >38°C, headache, etc) were present. DNA sequences were extracted from samples and amplified by Applied Biosystems TM 7500 RT-qPCR instrument (Thermo Fisher Scientific, USA). The CSF of all patients was collected when bacterial infection-like symptoms (T >38°C, neck stiffness, etc) were present, and transferred to different culture bottles (Bactec Plus Aerobic/F, Bactec Lytic/10 Anaerobic/F, Bactec Peds Plus/F) (Becton, Dickinson and Company Sparks, MD 21152 USA) immediately, and underwent etiology inspection by BacrecTM FX automated blood culture system (Becton, Dickinson and Company, USA) in microbiological laboratory. All serum and CSF samples from patients with AE were evaluated for NSAbs by IIF kits (Euroimmun, Lübeck, Germany) and CBA kits (Euroimmun, Lübeck, Germany) according to the manufacturer’s instructions. All patients underwent serum and CSF laboratory tests, including all of the following: CSF examinations included: Pandy test, intracranial pressure, WBC counts, protein levels, chloride, glucose, lactate dehydrogenase (LDH), lactic acid (Lac), adenosine deaminase (ADA) and C-reactive protein (CRP). Blood examinations included: leukocyte, erythrocyte and platelet counts, and the levels of sodium, potassium, calcium, and chlorine.
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6

Sonication and Culture of Periprosthetic Samples

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The removed osteosynthesis material was sent for sonication in sterile reusable
polypropylene containers according to a previously published protocol utilizing
a BactoSonic® 14.2 sonication unit (Bandelin Electronic GmbH, Berlin, Germany).13 (link) Additionally, synovial fluid (if present) was aspirated with a sterile
syringe before incision of the pseudocapsule and inoculated in blood culture
paediatric bottles (BacTec PedsPlus/F; Beckton Dickinson, Shannon, Ireland).
Tissue samples were placed in sterile containers without medium or saline. All
microbiological samples were processed according to a standard microbiological
protocol in both aerobic and anaerobic cultures incubated at 35 °C for 14 days.14 (link) Identification and susceptibility testing of isolated microorganisms was
performed using an automatic bacteriological analyser VITEK® 2 (bioMerieux,
Marcy L'Etoile, France).
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7

Neonatal Amikacin Pharmacokinetics Protocol

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Blood was collected via venipuncture from recruited neonates by a study physician before drug administration for the laboratory investigations described below. Blood samples were collected into pediatric culture vials (BACTEC Peds plus/F, Becton-Dickinson, Gauteng, South Africa) for culture and sensitivity, EDTA tubes for full blood count, and serum separator tubes for C-reactive protein (CRP) and procalcitonin (PCT) levels.
For amikacin levels, 1 or 2 blood samples (500 µL per sample) were collected from each neonate into separator tubes, centrifuged, and serum obtained immediately transferred into Eppendorf tubes. Blood samples collected for the purpose of determining peak amikacin levels were collected 1 hour after the third dose, and samples for trough levels were collected 30 minutes before the fourth dose. Other samples (apart from peak or trough) were collected after 2, 4, 6, or 8 hours (full PK screen) following the third amikacin dose.
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8

Diagnosis of Periprosthetic Infections

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A total of 0.1 ml of the SF was directly inoculated into blood plates for bacterial and fungal culture. The remaining SF was injected into Bactec Plus/F aerobic or Bactec Peds Plus/F blood culture bottles and anaerobic blood culture bottles (Becton-Dickinson, Germany). The plates and bottles were incubated for 14 days in a Bactec 9050 automatic incubator (Becton-Dickinson, Germany). The periprosthetic tissue was cut into pieces, added to the broth for grinding, and then cultured for aerobic and anaerobic bacteria on a blood plate for 14 days. The Vitek II system (bioMérieux, USA) was used for microbial identification and antibiotic susceptibility testing.
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9

Prompt Processing of Positive Yeast BCs

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Positive monomicrobial BCs containing yeasts as detected by Gram stain were prospectively included into the study from February to September 2013. All types of BC bottles (BACTEC Plus Aerobic/F, BACTEC Plus Anaerobic/F, BACTEC Mycosis-IC/F and BACTEC Peds Plus/F, BD Diagnostics, Heidelberg, Germany) incubated in an automated BC system (BACTEC 9240, BD Diagnostics) were included. If the samples could not be investigated immediately after positive signal, they were kept for study activities in refrigerator for maximum one day. A preliminary experiment has demonstrated that the cell number in positive BC bottles only minimally changes if bottles are kept at +5.5°C for up to three days compared to a considerable CFU increase at room temperature (data not shown). The median time from yeast detection by Gram stain of a positive BC broth to the processing according to the study protocol was 4.8 h (range 19 min to 24.2 h). All routine diagnostics of positive BCs were performed immediately.
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10

Blood Culture Identification and Antibiotic Susceptibility

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Aseptically collected blood was inoculated into BACTEC PEDS PLUS/F and BACTEC LYTIC Anaerobic/F Bactec Plus (BACTEC 9240, BD, Sparks, MD, USA). Species identification and antimicrobial susceptibilities were performed using the MicroScan WalkAway 96 plus system and Neg Combo Panel Type 72 (Beckman Coulter, Brea, CA, USA). ESBL producers were determined according to the Clinical and Laboratory Standards Institute M100 (2019) (25 ), which measures the minimum inhibitory concentration around both cefotaxime and ceftazidime disks with or without clavulanate for E. coliK. pneumoniaeK. oxytoca, and Proteus mirabilis.
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