COMPARISON OF BEDSIDE-INOCULATED AND LABORATORY-INOCULATED BACTEC HIGH-VOLUME AND LOW-VOLUME RESIN BOTTLES FOR THE RECOVERY OF MICROORGANISMS CAUSING PERITONITIS IN CAPD PATIENTS

There is not yet a universally accepted protocol for the recovery of m icroorganisms causing peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD). We prospectively analyzed 343 peritoneal effluent specimens by tl ee protocols: 1) 10 ml of effluent centrifuge d and the pellet plated onto blood, MacConkey agars, and into thioglyc olate broth (routine method); 2) 5 ml and 10 ml inoculated at the beds ide into Bactec 16A and 26A aerobic resin-containing blood culture bot tles, respectively; and 3) 5 mi and 10 mi inoculated in the laboratory into Bactec 16A and 26A media, respectively. One hundred and forty (4 1%) peritoneal effluent specimens had microorganisms recovered, and, o f these, 101 were recovered by routine culture compared to 117 (p <.02 1), 125 (p <.0001), 115 (p <.047), and 116 (p <.032) for bedside-inocu lated 16A and 26A and for laboratory-inoculated 16A and 26A, respectiv ely. Bedside-inoculated bottles were not significantly better than lab oratory-inoculated bottles, and high-volume bottles were not significa ntly better than low-volume bottles for detection of patients positive for microorganisms; however, the number of total microorganisms recov ered were significantly better from all inoculated blood culture bottl es compared to routine culture. Bedside-and laboratory-inoculated resi n-containing blood culture bottles are superior to the routine method for recovery of microorganisms causing peritonitis bz CAPD patients. ( C) 1998 Elsevier Science Inc.