Comparison and Evaluation of Neutralization of Clinically Frequently Used Antimicrobial Agents Using Three Different Culture Media in Simulated Blood Cultures

Abstract

The performance of BACT/ALERT FA/FN Plu (France) blood culture containing a novel resin, DL (China) blood culture containing common resin, and adsorbent-free Thermo (USA) blood culture relying on dilution for antimicrobial neutralization at %peak serum concentration was evaluated by measuring the recovery of organisms and time to detection (TTD) in nine simulated microorganism-antimicrobial combination blood cultures.There was a significant difference in recovery rates between the aerobic media: 35/40 (87.5%) for BACT/ALERT media, 15/35 (42.9%) for DL media, and 5/40 (12.5%) for Thermo media; whereas, there was no statistical difference in TTD between FA Plus media and DL aerobic media. The recovery rates of the anaerobic media were 32/35 (91.4%) for BACT/ALERT media, 1/35 (2.9%) for DL media, and 5/35 (14.3%) for Thermo media, with significant differences only between BACT/ALERT FN Plus media and the others. Among the seven main antimicrobial categories, only BACT/ALERT FA/FN Plus culture media showed high recovery of microorganisms, except for carbapenems. The DL culture media exhibited a relatively high recovery rate of piperacillin/tazobactam, levofloxacin, and gentamicin only in aerobic media, and Thermo media only displayed the recovery of gentamicin.BACT/ALERT FA/FN Plus culture media with novel resin showed absolute advantages over DL and Thermo culture media and, thus, can be selectively applied clinically with prior use of antimicrobials before pathogen detection. DL culture media containing common resin outperformed adsorbent-free dilution-based Thermo culture media, which can be a backup option. We should focus on improving the neutralization of carbapenems with low efficiency in all three media.