False no-growth blood cultures in pneumococcal pneumonia

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Abstract
The growth of Streptococcus pneumoniae in commercial media containing 14C-labeled substrates was studied experimentally; the results of blood cultures that were positive for S. pneumoniae over 14 mo. were analyzed to explain no-growth but radiometrically positive blood cultures from 4 patients with clinically diagnosed pneumococcal pneumonia. The growth of S. pneumoniae in aerobic blood culture vials resulted in a chocolate color in the medium. S. pneumoniae grew rapidly in aerobic and anaerobic media but 14CO2 evolved from the metabolism of the labeled substrates was detected only in the aerobic culture vials. Radiometric detection lagged behind growth of the organisms and was accompanied by visual changes in the media. By 24 h, the viability of the culture was on the decline; radiometric readings remained positive even when the culture died.