Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection

ABSTRACT Microbiological diagnosis of pleural infection is often hindered by the low sensitivity of conventional culture. The automated blood culture system (ABCS) has been shown to improve diagnostic sensitivity for the culture of non-blood specimens. This study examined the additional diagnostic b...

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Main Authors: Young Ho Lee, Min Seo Kang, Jinyoung Yang, Si-Ho Kim, Jae-Hoon Ko, Sun Young Cho, Tae Yeul Kim, Hee Jae Huh, Nam Yong Lee, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Kyungmin Huh
Format: Article
Language:English
Published: American Society for Microbiology 2025-08-01
Series:Microbiology Spectrum
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Online Access:https://journals.asm.org/doi/10.1128/spectrum.00352-25
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author Young Ho Lee
Min Seo Kang
Jinyoung Yang
Si-Ho Kim
Jae-Hoon Ko
Sun Young Cho
Tae Yeul Kim
Hee Jae Huh
Nam Yong Lee
Cheol-In Kang
Doo Ryeon Chung
Kyong Ran Peck
Kyungmin Huh
author_facet Young Ho Lee
Min Seo Kang
Jinyoung Yang
Si-Ho Kim
Jae-Hoon Ko
Sun Young Cho
Tae Yeul Kim
Hee Jae Huh
Nam Yong Lee
Cheol-In Kang
Doo Ryeon Chung
Kyong Ran Peck
Kyungmin Huh
author_sort Young Ho Lee
collection DOAJ
description ABSTRACT Microbiological diagnosis of pleural infection is often hindered by the low sensitivity of conventional culture. The automated blood culture system (ABCS) has been shown to improve diagnostic sensitivity for the culture of non-blood specimens. This study examined the additional diagnostic benefit of ABCS against conventional bacterial culture in patients who underwent thoracentesis or percutaneous drainage. Non-duplicate patients whose pleural fluid samples were tested using both conventional culture and ABCS (BACT/ALERT 3D and VIRTUO, bioMerieux) from 2001 through 2021 were included. Cases were excluded if only contaminants such as coagulase-negative staphylococci, Corynebacterium species, and Bacillus species were identified. Data on culture results, demographics, and laboratory tests were collected. Of the 9,020 patients, 632 patients had positive results in ABCS after excluding those considered contaminants (n = 180) or those positive only in conventional culture (n = 5). Conventional culture was positive in 302 (47.8%) patients, whereas 330 (52.2%) patients had isolates only from ABCS. Patients with positive results from ABCS alone had lower pleural fluid lactate dehydrogenase and serum C-reactive protein (CRP) and higher pleural fluid glucose and protein. Among organisms isolated from ABCS alone, viridans group streptococci, Staphylococcus aureus, and Klebsiella spp. were the most common organisms identified. Higher pleural fluid glucose and blood white blood cells and lower CRP were significant factors associated with exclusive ABCS positivity. More than half of the patients whose pleural fluid cultures were positive using ABCS had a negative result on conventional culture. Our results suggest that ABCS might enhance the microbiologic diagnosis of pleural infection.IMPORTANCEThis study demonstrated that an automated blood culture system (ABCS) has superior sensitivity in pleural infections compared with conventional culture. By comparing both methods in over 9,000 patients, researchers found that ABCS detected bacteria in approximately twice as many cases as conventional culture, especially in patients with a high probability of pleural infection. The findings suggest that ABCS can be a valuable tool in improving the accuracy of diagnosing pleural infections, which could lead to better treatment decisions and patient outcomes.
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spelling doaj-art-c3787935bb284eb2945541ff9fa1e6162025-08-20T03:38:59ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972025-08-0113810.1128/spectrum.00352-25Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infectionYoung Ho Lee0Min Seo Kang1Jinyoung Yang2Si-Ho Kim3Jae-Hoon Ko4Sun Young Cho5Tae Yeul Kim6Hee Jae Huh7Nam Yong Lee8Cheol-In Kang9Doo Ryeon Chung10Kyong Ran Peck11Kyungmin Huh12Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaABSTRACT Microbiological diagnosis of pleural infection is often hindered by the low sensitivity of conventional culture. The automated blood culture system (ABCS) has been shown to improve diagnostic sensitivity for the culture of non-blood specimens. This study examined the additional diagnostic benefit of ABCS against conventional bacterial culture in patients who underwent thoracentesis or percutaneous drainage. Non-duplicate patients whose pleural fluid samples were tested using both conventional culture and ABCS (BACT/ALERT 3D and VIRTUO, bioMerieux) from 2001 through 2021 were included. Cases were excluded if only contaminants such as coagulase-negative staphylococci, Corynebacterium species, and Bacillus species were identified. Data on culture results, demographics, and laboratory tests were collected. Of the 9,020 patients, 632 patients had positive results in ABCS after excluding those considered contaminants (n = 180) or those positive only in conventional culture (n = 5). Conventional culture was positive in 302 (47.8%) patients, whereas 330 (52.2%) patients had isolates only from ABCS. Patients with positive results from ABCS alone had lower pleural fluid lactate dehydrogenase and serum C-reactive protein (CRP) and higher pleural fluid glucose and protein. Among organisms isolated from ABCS alone, viridans group streptococci, Staphylococcus aureus, and Klebsiella spp. were the most common organisms identified. Higher pleural fluid glucose and blood white blood cells and lower CRP were significant factors associated with exclusive ABCS positivity. More than half of the patients whose pleural fluid cultures were positive using ABCS had a negative result on conventional culture. Our results suggest that ABCS might enhance the microbiologic diagnosis of pleural infection.IMPORTANCEThis study demonstrated that an automated blood culture system (ABCS) has superior sensitivity in pleural infections compared with conventional culture. By comparing both methods in over 9,000 patients, researchers found that ABCS detected bacteria in approximately twice as many cases as conventional culture, especially in patients with a high probability of pleural infection. The findings suggest that ABCS can be a valuable tool in improving the accuracy of diagnosing pleural infections, which could lead to better treatment decisions and patient outcomes.https://journals.asm.org/doi/10.1128/spectrum.00352-25pleural infectionconventional cultureautomated blood culture
spellingShingle Young Ho Lee
Min Seo Kang
Jinyoung Yang
Si-Ho Kim
Jae-Hoon Ko
Sun Young Cho
Tae Yeul Kim
Hee Jae Huh
Nam Yong Lee
Cheol-In Kang
Doo Ryeon Chung
Kyong Ran Peck
Kyungmin Huh
Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection
Microbiology Spectrum
pleural infection
conventional culture
automated blood culture
title Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection
title_full Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection
title_fullStr Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection
title_full_unstemmed Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection
title_short Comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection
title_sort comparison of conventional culture and automated blood culture system for microbiologic diagnosis of pleural infection
topic pleural infection
conventional culture
automated blood culture
url https://journals.asm.org/doi/10.1128/spectrum.00352-25
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