Evaluation of Negative Results of BacT/Alert 3D Automated Blood Culture System

Although automated continuous-monitoring blood culture systems are both rapid and sensitive, false-positive and false-negative results still occur. The objective of this study, then, was to evaluate negative results occurring with BacT/Alert 3D blood culture systems. A total of 1032 samples were cultured with the BacT/Alert 3D automated blood culture system, using both aerobic (BPA) and anaerobic (BPN) media, and 128 of these samples yielded positive results. A total of 904 negative blood samples were then subcultured in $5\%$ sheep blood agar, eosin methylene blue, chocolate agar, and sabouraud-dextrose agar. Organisms growing on these subcultures were subsequently identified using both Vitek32 (bioMerieux, Durham, NC) and conventional methods. Twenty four $(2.6\%)$ of the 904 subcultures grew on the subculture media. The majority $(83.3\%)$ of these were determined to be gram-positive microorganisms. Fourteen $(58.3\%)$ were coagulase-negative staphylococci, two $(8.3\%)$ were Bacillus spp., one $(4.2\%)$ was Staphylococcus aureus, and one $(4.2\%)$ was identified as Enterococcus faecium. Streptococcus pneumoniae and Neisseria spp. were isolated together in two $(8.3\%)$ vials. Gram-negative microorganisms comprised $12.5\%$ of the subcultures, of which two $(8.3\%)$ were found to be Pseudomonas aeruginosa, and one $(4.2\%)$ was Pseudomonas fluorescens. The other isolate $(4.2\%)$ was identified as Candida albicans. We conclude that the subculture of negative results is valuable in the BacT/Alert 3D system, especially in situations in which only one set of blood cultures is taken.