Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov 22;57(12):e01344-19.
doi: 10.1128/JCM.01344-19. Print 2019 Dec.

Effect of Clinically Meaningful Antibiotic Concentrations on Recovery of Escherichia coli and Klebsiella pneumoniae Isolates from Anaerobic Blood Culture Bottles with and without Antibiotic Binding Resins

Iris H Chen  1 , David P Nicolau  1 , Joseph L Kuti  2
Affiliations

Effect of Clinically Meaningful Antibiotic Concentrations on Recovery of Escherichia coli and Klebsiella pneumoniae Isolates from Anaerobic Blood Culture Bottles with and without Antibiotic Binding Resins

Iris H Chen et al. J Clin Microbiol. .

Abstract

Blood cultures are routinely collected in pairs of aerobic and anaerobic bottles. Artificial sterilization of Gram-negative bacteria in aerobic bottles containing clinically meaningful antibiotic concentrations has previously been observed. This study assessed recovery from anaerobic bottles with and without antibiotic binding resins. We studied the recovery of Escherichia coli and Klebsiella pneumoniae when exposed to meropenem, imipenem, cefepime, cefazolin, levofloxacin, and piperacillin-tazobactam in resin-containing BacT/Alert FN Plus and BD Bactec Plus anaerobic/F bottles as well as resin-free BacT/Alert SN and BD Bactec standard anaerobic bottles. Bottles were inoculated with bacteria and whole blood containing peak, midpoint, or trough concentrations and incubated for up to 120 hours in their respective detection systems. In E. coli resin-containing bottles, recovery was observed in 10/24 (42%), 17/24 (71%), and 18/24 (75%) (P = 0.034) of those exposed to peak, midpoint, and trough concentrations, respectively. In K. pneumoniae resin-containing bottles, recovery was observed in 8/16 (50%), 10/16 (63%), and 10/16 (63%) (P = 0.710), respectively. No growth was detected in bottles containing cefepime regardless of concentration, while recovery was observed in the presence of all concentrations of cefazolin and piperacillin-tazobactam. Recovery in bottles with meropenem and imipenem was more frequently observed in BacT/Alert FN Plus bottles compared with Bactec Plus bottles. Resin-free bottles demonstrated significantly lower recovery than bottles containing binding resin. Clinical concentrations of certain antibiotics can adversely affect detection of E. coli and K. pneumoniae in anaerobic blood culture bottles. Obtaining blood cultures immediately before a dose and utilizing resin-containing anaerobic bottles will maximize the likelihood of recovery.

Keywords: Escherichia coli; Klebsiella pneumoniae; antimicrobial stewardship; bacteremia; carbapenem; cephalosporin; levofloxacin; piperacillin.

PubMed Disclaimer

Figures

FIG 1
FIG 1
Meropenem (A), cefazolin (B), cefepime (C), and piperacillin (D) concentrations over the initial 12 hours upon inoculating blood culture bottles with antibiotic and applicable study isolate MICs.
See this image and copyright information in PMC

References

    1. Goto M, Al-Hasan MN. 2013. Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe. Clin Microbiol Infect 19:501–509. doi:10.1111/1469-0691.12195. - DOI - PubMed
    1. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, et al. . 2017. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 45:486–552. doi:10.1097/CCM.0000000000002255. - DOI - PubMed
    1. Grohs P, Mainardi JL, Podglajen I, Hanras X, Eckert C, Buu-Hoi A, Varon E, Gutmann L. 2007. Relevance of routine use of the anaerobic blood culture bottle. J Clin Microbiol 45:2711–2715. doi:10.1128/JCM.00059-07. - DOI - PMC - PubMed
    1. Marcos M, Soriano A, Iñurrieta A, Martínez JA, Romero A, Cobos N, Hernández C, Almela M, Marco F, Mensa J. 2011. Changing epidemiology of central venous catheter-related bloodstream infections: increasing prevalence of Gram-negative pathogens. J Antimicrob Chemother 66:2119–2125. doi:10.1093/jac/dkr231. - DOI - PubMed
    1. Braun E, Hussein K, Geffen Y, Rabino G, Bar-Lavie Y, Paul M. 2014. Predominance of Gram-negative bacilli among patients with catheter-related bloodstream infections. Clin Microbiol Infect 20:O627–O629. doi:10.1111/1469-0691.12565. - DOI - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources