Reassessment of the routine anaerobic culture and incubation time in the BacT/alert FAN blood culture bottles

A total of 9,130 blood cultures were collected from adult patients with sus pected bloodstream infections. The recommended 20 mt sample of blood was di vided equally between the aerobic and anaerobic FAN bottles and monitored i n the BacT/Alert Microbial Detection System for a total of 5 days. There we re 757 clinically significant positive culture pairs from 291 patients. Sig nificant differences were found with greater recovery of Pseudomonas aerugi nosa (p < 0.001), Acinetobacter spp. (p = 0.002), coagulase-negative staphy lococci other than Staphylococcus epidermidis (p = 0.002), and Candida spp. (p < 0.001) from the aerobic bottle and greater recovery of anaerobic bact eria (p < 0.001) from the anaerobic bottle. Significantly move episodes of P. aeruginosa bacteremia (p < 0.003) and candidemia (p < 0.001) were detect ed by the aerobic FAN bottle and significantly more episodes of anaerobic b acteremia (p < 0.001) were detected by the anaerobic FAN bottle (Table 2). No other significant differences between systems in their defection of bact eremias were noted. Anaerobic bacteremias were encountered in diverse and o ften unpredictable clinical settings. All clinically significant episodes o f bloodstream infection were detected within 4 days of incubation of their cultures. We conclude routine, rather than selective, use of the anaerobic FAN bottle in the blood culture set and a B-day incubation of blood culture s in the BacT/Alert aerobic and anaerobic FAN bottles is an appropriate rou tine procedure. (C) 1999 Elsevier Science Inc.