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Diagnosis of staph

lamb L.A.M.Buisman at chello.nl
Fri May 4 09:20:11 EST 2001


Prssnblu wrote:

> We program our Bactec 9640 ( is that the correct model # ?) when the ID docs
> make a special request, usually for 21 or 28 days. We also have the machine
> programmed for afb and fungus blood cultures for 42 and 28 days (special media
> is used). Routine cultures are programmed for 5 days from insertion into the
> machine. With the fluorometric detection device, we've gotten coliforms growing
> from blood cultures to detectable levels in 8 hours. The best I've ever seen
> for a pneumococci was 12 hours. Rarely have I seen a significant staph grow out
> after 4 days, even when the docs have requested we hold the cultures longer.
> We no longer subculture our bottles because of the sensitivity of the
> fluorometric system and because it is continuously monitored. We have the
> Bactec interfaced with the lab computer and all we have to do is barcode the
> bottle sticker and the patient sticker and let the machine do all the work,
> paper work included. We have three of the big 300 bottle incubators and it
> would taker an army to blind sub the specimens. We do blind sub when the
> machine flags the bottle and we see no organisms on gram stain. This occurance
> is rare and usually due to overfilling of the bottle or to a high patient white
> count.
> This machine is wonderful.

I believe you. I want them too. The Vital is a terrible machine, the medium is bad,
5 days for routine is not long enough, and it is expensive to run.
We chose it at the time because the bottles have screw-tops. We do not want to use
syringes and needles in the lab, and definitely not with blood.
All I need now is a safe device to draw samples from positive bottles and then my
boss will agree to the Bactec.

As for "slow" staphylococci in bloodcultures, they are rare, but in endocarditis
anything is possible.

Loes





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