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Volume 69, Issue 7

Does concomitant bacteraemia hide the fungi in blood cultures? An in vitro study Free

Abstract

Polymicrobial infections including yeasts and bacteria are not rare and patients with polymicrobial bloodstream infection have higher early and overall case fatality rates. The diagnosis of invasive fungal and bacterial infections is mainly based on blood culture.

The aim was to reveal the effect of concomitant bacteraemia on the detection of fungi from blood cultures in the presence of polymicrobial bloodstream infections involving and non- fungi and to show the superiority of blood culture bottles including selective fungal media in such situations.

Twenty-four polymicrobial bloodstream infection models – involving one fungus and one bacterium – were constituted by using clinical blood culture isolates (, , , , , and ). The Plus Aerobic/F (PAF) and Mycosis IC/F (MICF) culture bottles were used with the BACTEC 9240 device. After a bottle signalled positive, direct microscopic examination and subcultures on agar plates were performed.

All of fungi that were inoculated alone and in combination were detected by both direct microscopic examination and subcultures on agar plates from MICF bottles, whereas direct microscopic examination only revealed the bacterial agents from PAF bottles including combinations. Furthermore, fungal growth was hidden by bacterial growth on blood agar subcultures from PAF bottles including combinations of , or with bacteria.

Blood culture bottles including selective fungal media that can allow selective growth of fungi and earlier detection of some species should be preferred in addition to non-selective blood culture bottles, especially in specific patient populations. Further, the use of selective agar plates such as inhibitory mould agar may contribute to the solution of this problem in clinical laboratories.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): blood culture , Candida , Fusarium , polymicrobial and Trichosporon
© 2020 The Authors
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2020-06-03
2024-04-16
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References

  1. Cornely OA, Gachot B, Akan H, Bassetti M, Uzun O et al. Epidemiology and outcome of fungemia in a cancer cohort of the infectious diseases group (IDG) of the European organization for research and treatment of cancer (EORTC 65031). Clin Infect Dis 2015; 61:324–331 [View Article][PubMed]
     [Google Scholar]
  2. Criscuolo M, Marchesi F, Candoni A, Cattaneo C, Nosari A et al. SEIFEM group (Sorveglianza Epidemiologica Infezioni nelle Emopatie). fungaemia in haematological malignancies: SEIFEM-2015 survey. Eur J Clin Invest 2019; 49:e13083
     [Google Scholar]
  3. Arendrup MC, Sulim S, Holm A, Nielsen L, Nielsen SD et al. Diagnostic issues, clinical characteristics, and outcomes for patients with fungemia. J Clin Microbiol 2011; 49:3300–3308 [View Article][PubMed]
     [Google Scholar]
  4. McKenzie FE. Case mortality in polymicrobial bloodstream infections. J Clin Epidemiol 2006; 59:760–761 [View Article][PubMed]
     [Google Scholar]
  5. Royo-Cebrecos C, Gudiol C, Ardanuy C, Pomares H, Calvo M et al. A fresh look at polymicrobial bloodstream infection in cancer patients. PLoS One 2017; 12:e0185768 [View Article][PubMed]
     [Google Scholar]
  6. Klingspor L, Muhammed SA, Ozenci V. Comparison of the two blood culture systems, Bactec 9240 and BacT/Alert 3D, in the detection of Candida spp. and bacteria with polymicrobial sepsis. Eur J Clin Microbiol Infect Dis 2012; 31:2983–2987 [View Article][PubMed]
     [Google Scholar]
  7. Cateau E, Cognee A-S, Tran TC, Vallade E, Garcia M et al. Impact of yeast-bacteria coinfection on the detection of Candida sp. in an automated blood culture system. Diagn Microbiol Infect Dis 2012; 72:328–331 [View Article][PubMed]
     [Google Scholar]
  8. Gokbolat E, Oz Y, Metintas S. Evaluation of three different bottles in BACTEC 9240 automated blood culture system and direct identification of Candida species to shorten the turnaround time of blood culture. J Med Microbiol 2017; 66:470–476 [View Article][PubMed]
     [Google Scholar]
  9. Nucci M, Anaissie E. Fusarium infections in immunocompromised patients. Clin Microbiol Rev 2007; 20:695–704 [View Article][PubMed]
     [Google Scholar]
  10. Lin SY, PL L, Tan BH, Chakrabarti A, UI W et al. Asia fungal Working Group (AFWG). The epidemiology of non-Candida yeast isolated from blood: the Asia surveillance study. Mycoses 2019; 62:112–120
     [Google Scholar]
  11. Xu L, Wang F, Shen Y, Hou H, Liu W et al. Pseudomonas aeruginosa inhibits the growth of pathogenic fungi: In vitro and in vivo studies. Exp Ther Med 2014; 7:1516–1520 [View Article][PubMed]
     [Google Scholar]
  12. Amin R, Dupuis A, Aaron SD, Ratjen F. The effect of chronic infection with Aspergillus fumigatus on lung function and hospitalization in patients with cystic fibrosis. Chest 2010; 137:171–176 [View Article][PubMed]
     [Google Scholar]
  13. Chotirmall SH, Greene CM, McElvaney NG. Candida species in cystic fibrosis: A road less travelled. Med Mycol 2010; 48 Suppl 1:S114–S124 [View Article][PubMed]
     [Google Scholar]
  14. Ericson E-L, Klingspor L, Ullberg M, Ozenci V. Clinical comparison of the Bactec Mycosis IC/F, BacT/Alert FA, and BacT/Alert FN blood culture vials for the detection of candidemia. Diagn Microbiol Infect Dis 2012; 73:153–156 [View Article][PubMed]
     [Google Scholar]
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Does concomitant bacteraemia hide the fungi in blood cultures? An in vitro study
J. Med. Microbiol. 69, 944 (2020); https://doi.org/10.1099/jmm.0.001210
/content/journal/jmm/10.1099/jmm.0.001210
/content/journal/jmm/10.1099/jmm.0.001210
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