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Performance of Gram staining on blood cultures flagged negative by an automated blood culture system

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Abstract

Blood is one of the most important specimens sent to a microbiology laboratory for culture. Most blood cultures are incubated for 5–7 days, except in cases where there is a suspicion of infection caused by microorganisms that proliferate slowly, or infections expressed by a small number of bacteria in the bloodstream. Therefore, at the end of incubation, misidentification of positive cultures and false-negative results are a real possibility. The aim of this work was to perform a confirmation by Gram staining of the lack of any microorganisms in blood cultures that were identified as negative by the BACTEC™ FX system at the end of incubation. All bottles defined as negative by the BACTEC FX system were Gram-stained using an automatic device and inoculated on solid growth media. In our work, 15 cultures that were defined as negative by the BACTEC FX system at the end of the incubation were found to contain microorganisms when Gram-stained. The main characteristic of most bacteria and fungi growing in the culture bottles that were defined as negative was slow growth. This finding raises a problematic issue concerning the need to perform Gram staining of all blood cultures, which could overload the routine laboratory work, especially laboratories serving large medical centers and receiving a large number of blood cultures.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Correspondence to A. Peretz.

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Peretz, A., Isakovich, N., Pastukh, N. et al. Performance of Gram staining on blood cultures flagged negative by an automated blood culture system. Eur J Clin Microbiol Infect Dis 34, 1539–1541 (2015). https://doi.org/10.1007/s10096-015-2383-0

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  • DOI: https://doi.org/10.1007/s10096-015-2383-0

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