Does concomitant bacteraemia hide the fungi in blood cultures? An in vitro study
Introduction. Polymicrobial infections including yeasts and bacteria are not rare and patients with polymicrobial bloodstream infection have higher early and overall case fatality rates. The diagnosis of invasive fungal and bacterial infections is mainly based on blood culture. Aim. The aim was to r...
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Published in | Journal of medical microbiology Vol. 69; no. 7; pp. 944 - 948 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
01.07.2020
|
Online Access | Get full text |
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Summary: | Introduction.
Polymicrobial infections including yeasts and bacteria are not rare and patients with polymicrobial bloodstream infection have higher early and overall case fatality rates. The diagnosis of invasive fungal and bacterial infections is mainly based on blood culture.
Aim.
The aim was to reveal the effect of concomitant bacteraemia on the detection of fungi from blood cultures in the presence of polymicrobial bloodstream infections involving
Candida
and non-
Candida
fungi and to show the superiority of blood culture bottles including selective fungal media in such situations.
Methodology.
Twenty-four polymicrobial bloodstream infection models – involving one fungus and one bacterium – were constituted by using clinical blood culture isolates (
Escherichia coli
,
Staphylococcus aureus
,
Pseudomonas aeruginosa
,
Candida albicans
,
Candida glabrata
,
Fusarium solani
and
Trichosporon asahii
). The Plus Aerobic/F (PAF) and Mycosis IC/F (MICF) culture bottles were used with the BACTEC 9240 device. After a bottle signalled positive, direct microscopic examination and subcultures on agar plates were performed.
Results.
All of fungi that were inoculated alone and in combination were detected by both direct microscopic examination and subcultures on agar plates from MICF bottles, whereas direct microscopic examination only revealed the bacterial agents from PAF bottles including combinations. Furthermore, fungal growth was hidden by bacterial growth on blood agar subcultures from PAF bottles including combinations of
F. solani
,
C. glabrata
or
T. asahii
with bacteria.
Conclusion.
Blood culture bottles including selective fungal media that can allow selective growth of fungi and earlier detection of some species should be preferred in addition to non-selective blood culture bottles, especially in specific patient populations. Further, the use of selective agar plates such as inhibitory mould agar may contribute to the solution of this problem in clinical laboratories. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0022-2615 1473-5644 |
DOI: | 10.1099/jmm.0.001210 |