Dear colleagues,
I would be very happy to receive any input or hear your experience
regarding the following issue:
We are currently in the process of planning a study on bacteremia in
pediatric patients with fever in a high HIV prevalence area (Tanzania,
East Africa). Due to the high prevalence of HIV, we expect that M.
tuberculosis and possibly fungi may be a significant contributor to the
bacteremias. Thus we want to be able to isolate these organisms in
addition to the more common bacteria.
We have been investigating several options for blood culturing systems
that will enable the isolation of all these organisms in a lab with
limited resources at hand. Among others we considered BBL SeptiCheck and
BBL SeptiCheck AFB, but these systems seem to be to expensive for our
budget.
Finally, we have considered the BACTEC Myco/F lytic system which
according to the product info and some references (see below) should be
reliable. The advantage of this system is that the one and same bottle
can be used for the identification of bacteria, as well as mycobacteria
and fungi. In addition, the procedures involved are simplified compared
to other systems (less risk of accidental needle injuries) and the
system is cheaper. One problem with the system may be that rapid growing
organisms (causative or contaminants) may disguise the growth of
slow-growing bacteria like M. tuberculosis if there are more than one
organism in the culture.
Does any of you have any experience with the BACTEC Myco/F lytic system?
Would it be reliable for the above mentioned purpose? Are there other
alternatives (must be resonably priced and feasible to use in a lab with
limited equipment and unreliable supplies of electricity)?
Thank you very much, in advance.
Bjorn Blomberg, MD
University of Bergen, Norway.
Muhimbili University College of Health Sciences, Dar es Salaam,
Tanzania.
