Time to blood culture positivity of Candida species

O.A. Akan1, S. Kilicel2

Author address: 

1Ankara University Medical School, ANKARA, Turkey 2Ankara University, ANKARA, Turkey

Abstract: 

Since mortality is higher with delayed treatment (more than 48 hours) in systemic Candida infections, early diagnosis is vitally important. The gold standard for the diagnosis of candidemia is a positive blood culture. Despite the availability of improved detection systems, time is still required to obatin a positive result. This study is performed to observe the time to detect positivity in the blood cultures in which Candida spp. were isolated. The retrospective analysis of records of blood cultures were done using Epi-Center (BD Diagnostics). The time of blood culture (BACTEC Plus + Aerobic /F ) bottles loaded into the BACTEC 9240 (BD Diagnostics) systems and the time of positive alarm were recorded. All of the bottles were incubated for 5 days. The mean duration of incubation until positivity was calculated for both all Candida spp. and for different species individually. The isolation of the microorganisms were done according to the standard microbiological procedures and identification of Candida spp. were done using Vitek 2 Compact system (bio-Merieux). During the 4 years between January 2005 and December 2008, there was growth of candida in 508 of 36.330 blood cultures. 315 (62%) were Candida albicans, 157 ( 31%) were non-albicans Candida and 36 (7%) were nontypeable. Among the non-albicans Candida the most frequent isolates were C.parapsilosis (104), C.tropicalis (17) and C.glabrata (12). Mean time to detect positivity in C.albicans was 1:14:00 days:hours:minutes (max: 5:14:03 and min: 00:02:11). In non albicans Candida it was 2:00:56 (max: 5:05:40 and min: 00:03:22). 21.2% of Candida displayed growth alarm after 48 hours. Mean isolation time was >48 hours in C.glabrata (12) and C.famata (6). Mean duration for positivity is higher in non albicans Candida. Even in C.albicans the time to positivity is still high to manage appropriate therapy. The subcultures and identification procedures will require at least 48 more hours. In each hospital there should be 24 hours coordination of information between laboratory and clinics in term of early management of systemic Candida infections. Faster methods of detection is required for laboratory dependent therapy.
2009

abstract No: 

P058

Full conference title: 

4th Trends in Medical Mycology
    • TIMM 4th (2012)