CLINICAL IMPORTANCE OF INCREASED SENSITIVITY OF BACT ALERT FAN AEROBIC AND ANAEROBIC BLOOD CULTURE BOTTLES/

Two recent multicenter blood culture studies found that BacT/Alert FAN (FAN) bottles (Organon Teknika, Durham, N.C.) had increased yields in detecting bacteremia and fungemia compared with standard BacT/Alert ( STD) bottles. Because the clinical importance of this increase in micr obial recovery is unknown, we performed a retrospective analysis to de termine the frequency with which FAN bottles were the sole means of de tecting an episode of bacteremia. There were 1,047 positive blood cult ures in which both study bottles were adequately filled and the organi sm isolated was judged to be the cause of sepsis: 240 (23%) were posit ive only in FAN bottles and 73 (7%) were positive only in STD bottles. Of a total of 664 episodes of bacteremia, 126 (19%) were identified o nly by FAN bottles and 43 (7%) were identified only by STD bottles (P < 0.0001). Episodes detected only by FAN bottles more often were recur rent events (23 of 126, or 18%) than episodes detected only by STD bot tles (2 of 43, or 5%) (P < 0.05) and more commonly occurred in patient s receiving theoretically effective antibiotic therapy (33 of 126 [26% ] versus 4 of 43 [9%]) (P < 0.05). The medical records for patients wi th 127 of these episodes (92 FAN bottles only; 35 STD bottles only) we re available for review. More than half of both FAN bottle-only (60 of 92, or 65%) and STD bottle-only (20 of 35, or 57%) episodes were judg ed to be clinically important. We conclude that FAN bottles improve th e detection of bacteremia and that the majority of the additional epis odes detected are clinically important. The benefits of the greater yi eld in specific patient populations must be balanced against the highe r costs of FAN bottles.