Value of terminal subcultures for blood cultures monitored by BACTEC 9240

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Abstract
Blood cultures collected in BACTEC Plus Aerobic/F bottles and BACTEC Plus Anaerobic/F bottles were monitored for 5 days by BACTEC 9240 and subsequent terminal subcultures. Of the 13,471 bottles subcultured, 11.0% (1,477 of 13,471) were culture positive. Of these, 94.0% (1,388 of 1,477) were detected by BACTEC 9240; the additional 6.0% (89 of 1,477) were considered to be false negatives by BACTEC 9240 since they were detected by terminal subculture only. The false-negative bottles consisted of 17 BACTEC Plus Aerobic/F and 72 BACTEC Plus Anaerobic/F bottles, accounting for 2.2 (17 of 786) and 10.4% (72 of 691) of the total positive aerobic and anaerobic bottles, respectively. The positive blood culture bottles most frequently not detected by BACTEC 9240 grew Pseudomonas spp. (24), Staphylococcus spp. (21), and yeasts (24). Of the 86 blood cultures represented by the 89 false-negative bottles, 41 would not have been identified as positive since the other bottle in the blood culture set was either a false negative or a true negative. In general, terminal subcultures of false-negative BACTEC bottles had heavy growth, indicating that BACTEC Plus media were able to support the growth of microorganisms, but the BACTEC 9240 instrument was unable to detect this growth.