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Published in: BMC Infectious Diseases 1/2008

Open Access 01-12-2008 | Research article

Blood culture collection technique and pneumococcal surveillance in Malawi during the four year period 2003–2006: an observational study

Authors: Neema Mtunthama, Stephen B Gordon, Temwa Kusimbwe, Eduard E Zijlstra, Malcolm E Molyneux, Neil French

Published in: BMC Infectious Diseases | Issue 1/2008

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Abstract

Background

Blood culture surveillance will be used for assessing the public health effectiveness of pneumococcal conjugate vaccines in Africa. Between 2003 and 2006 we assessed blood culture outcome and performance in adult patients in the central public hospital in Blantyre, Malawi, before and after the introduction of a dedicated nurse led blood culture team.

Methods

A prospective observational study.

Results

Following the introduction of a specialised blood culture team in 2005, the proportion of contaminated cultures decreased (19.6% in 2003 to 5.0% in 2006), blood volume cultured increased and pneumococcal recovery increased significantly from 2.8% of all blood cultures to 6.1%. With each extra 1 ml of blood cultured the odds of recovering a pneumococcus increased by 18%.

Conclusion

Standardisation and assessment of blood culture performance (blood volume and contamination rate) should be incorporated into pneumococcal disease surveillance activities where routine blood culture practice is constrained by limited resources.
Literature
1.
go back to reference Ssali FN, Kamya MR, Wabwire-Mangen F, Kasasa S, Joloba M, Williams D, Mugerwa RD, Ellner JJ, Johnson JL: A prospective study of community-acquired bloodstream infections among febrile adults admitted to Mulago Hospital in Kampala, Uganda. J Acquir Immune Defic Syndr Hum Retrovirol. 1998, 19 (5): 484-489.CrossRefPubMed Ssali FN, Kamya MR, Wabwire-Mangen F, Kasasa S, Joloba M, Williams D, Mugerwa RD, Ellner JJ, Johnson JL: A prospective study of community-acquired bloodstream infections among febrile adults admitted to Mulago Hospital in Kampala, Uganda. J Acquir Immune Defic Syndr Hum Retrovirol. 1998, 19 (5): 484-489.CrossRefPubMed
2.
go back to reference Archibald LK, McDonald LC, Nwanyanwu O, Kazembe P, Dobbie H, Tokars J, Reller LB, Jarvis WR: A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy. J Infect Dis. 2000, 181 (4): 1414-1420. 10.1086/315367.CrossRefPubMed Archibald LK, McDonald LC, Nwanyanwu O, Kazembe P, Dobbie H, Tokars J, Reller LB, Jarvis WR: A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy. J Infect Dis. 2000, 181 (4): 1414-1420. 10.1086/315367.CrossRefPubMed
3.
go back to reference Bell M, Archibald LK, Nwanyanwu O, Dobbie H, Tokars J, Kazembe PN, Reller LB, Jarvis WR: Seasonal variation in the etiology of bloodstream infections in a febrile inpatient population in a developing country. Int J Infect Dis. 2001, 5 (2): 63-69. 10.1016/S1201-9712(01)90027-X.CrossRefPubMed Bell M, Archibald LK, Nwanyanwu O, Dobbie H, Tokars J, Kazembe PN, Reller LB, Jarvis WR: Seasonal variation in the etiology of bloodstream infections in a febrile inpatient population in a developing country. Int J Infect Dis. 2001, 5 (2): 63-69. 10.1016/S1201-9712(01)90027-X.CrossRefPubMed
4.
go back to reference Gordon MA, Walsh AL, Chaponda M, Soko D, Mbvwinji M, Molyneux ME, Gordon SB: Bacteraemia and mortality among adult medical admissions in Malawi – predominance of non-typhi salmonellae and Streptococcus pneumoniae. J Infect. 2001, 42 (1): 44-49. 10.1053/jinf.2000.0779.CrossRefPubMed Gordon MA, Walsh AL, Chaponda M, Soko D, Mbvwinji M, Molyneux ME, Gordon SB: Bacteraemia and mortality among adult medical admissions in Malawi – predominance of non-typhi salmonellae and Streptococcus pneumoniae. J Infect. 2001, 42 (1): 44-49. 10.1053/jinf.2000.0779.CrossRefPubMed
5.
go back to reference Arthur G, Nduba VN, Kariuki SM, Kimari J, Bhatt SM, Gilks CF: Trends in bloodstream infections among human immunodeficiency virus-infected adults admitted to a hospital in Nairobi, Kenya, during the last decade. Clin Infect Dis. 2001, 33 (2): 248-256. 10.1086/321820.CrossRefPubMed Arthur G, Nduba VN, Kariuki SM, Kimari J, Bhatt SM, Gilks CF: Trends in bloodstream infections among human immunodeficiency virus-infected adults admitted to a hospital in Nairobi, Kenya, during the last decade. Clin Infect Dis. 2001, 33 (2): 248-256. 10.1086/321820.CrossRefPubMed
6.
go back to reference Peters RP, Zijlstra EE, Schijffelen MJ, Walsh AL, Joaki G, Kumwenda JJ, Kublin JG, Molyneux ME, Lewis DK: A prospective study of bloodstream infections as cause of fever in Malawi: clinical predictors and implications for management. Trop Med Int Health. 2004, 9 (8): 928-934. 10.1111/j.1365-3156.2004.01288.x.CrossRefPubMed Peters RP, Zijlstra EE, Schijffelen MJ, Walsh AL, Joaki G, Kumwenda JJ, Kublin JG, Molyneux ME, Lewis DK: A prospective study of bloodstream infections as cause of fever in Malawi: clinical predictors and implications for management. Trop Med Int Health. 2004, 9 (8): 928-934. 10.1111/j.1365-3156.2004.01288.x.CrossRefPubMed
7.
go back to reference Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, Reingold A, Cieslak PR, Pilishvili T, Jackson D, Facklam RR, Jorgensen JH, Schuchat A: Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med. 2003, 348 (18): 1737-1746. 10.1056/NEJMoa022823.CrossRefPubMed Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, Reingold A, Cieslak PR, Pilishvili T, Jackson D, Facklam RR, Jorgensen JH, Schuchat A: Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med. 2003, 348 (18): 1737-1746. 10.1056/NEJMoa022823.CrossRefPubMed
8.
go back to reference Hall MM, Ilstrup DM, Washington JA: Effect of volume of blood cultured on detection of bacteremia. J Clin Microbiol. 1976, 3 (6): 643-645.PubMedPubMedCentral Hall MM, Ilstrup DM, Washington JA: Effect of volume of blood cultured on detection of bacteremia. J Clin Microbiol. 1976, 3 (6): 643-645.PubMedPubMedCentral
9.
go back to reference Sandven P, Hoiby EA: The importance of blood volume cultured on detection of bacteraemia. Acta Pathol Microbiol Scand [B]. 1981, 89 (3): 149-152. Sandven P, Hoiby EA: The importance of blood volume cultured on detection of bacteraemia. Acta Pathol Microbiol Scand [B]. 1981, 89 (3): 149-152.
10.
go back to reference Plorde JJ, Tenover FC, Carlson LG: Specimen volume versus yield in the BACTEC blood culture system. J Clin Microbiol. 1985, 22 (2): 292-295.PubMedPubMedCentral Plorde JJ, Tenover FC, Carlson LG: Specimen volume versus yield in the BACTEC blood culture system. J Clin Microbiol. 1985, 22 (2): 292-295.PubMedPubMedCentral
11.
go back to reference Mermel LA, Maki DG: Detection of bacteremia in adults: consequences of culturing an inadequate volume of blood. Ann Intern Med. 1993, 119 (4): 270-272.CrossRefPubMed Mermel LA, Maki DG: Detection of bacteremia in adults: consequences of culturing an inadequate volume of blood. Ann Intern Med. 1993, 119 (4): 270-272.CrossRefPubMed
12.
go back to reference Li J, Plorde JJ, Carlson LG: Effects of volume and periodicity on blood cultures. J Clin Microbiol. 1994, 32 (11): 2829-2831.PubMedPubMedCentral Li J, Plorde JJ, Carlson LG: Effects of volume and periodicity on blood cultures. J Clin Microbiol. 1994, 32 (11): 2829-2831.PubMedPubMedCentral
13.
go back to reference Brown DR, Kutler D, Rai B, Chan T, Cohen M: Bacterial concentration and blood volume required for a positive blood culture. J Perinatol. 1995, 15 (2): 157-159.PubMed Brown DR, Kutler D, Rai B, Chan T, Cohen M: Bacterial concentration and blood volume required for a positive blood culture. J Perinatol. 1995, 15 (2): 157-159.PubMed
14.
go back to reference Gordon MA, Walsh AL, Chaponda M, Soko D, Mbvwinji M, Molyneux EM, Gordon SB: Bacteraemia and mortality among adult medical admissions in Malawi – predominance of non-typhi Salmonellae and Streptococcus pneumoniae. J Infect. 2001, 42: 44-49. 10.1053/jinf.2000.0779.CrossRefPubMed Gordon MA, Walsh AL, Chaponda M, Soko D, Mbvwinji M, Molyneux EM, Gordon SB: Bacteraemia and mortality among adult medical admissions in Malawi – predominance of non-typhi Salmonellae and Streptococcus pneumoniae. J Infect. 2001, 42: 44-49. 10.1053/jinf.2000.0779.CrossRefPubMed
15.
go back to reference Gordon SB, Walsh AL, Chaponda M, Gordon MA, Soko D, Mbwvinji M, Molyneux ME, Read RC: Bacterial meningitis in Malawian adults: pneumococcal disease is common, severe, and seasonal. Clin Infect Dis. 2000, 31 (1): 53-57. 10.1086/313910.CrossRefPubMed Gordon SB, Walsh AL, Chaponda M, Gordon MA, Soko D, Mbwvinji M, Molyneux ME, Read RC: Bacterial meningitis in Malawian adults: pneumococcal disease is common, severe, and seasonal. Clin Infect Dis. 2000, 31 (1): 53-57. 10.1086/313910.CrossRefPubMed
16.
go back to reference Heffernan RT, Barrett NL, Gallagher KM, Hadler JL, Harrison LH, Reingold AL, Khoshnood K, Holford TR, Schuchat A: Declining incidence of invasive Streptococcus pneumoniae infections among persons with AIDS in an era of highly active antiretroviral therapy, 1995–2000. J Infect Dis. 2005, 191 (12): 2038-2045. 10.1086/430356.CrossRefPubMed Heffernan RT, Barrett NL, Gallagher KM, Hadler JL, Harrison LH, Reingold AL, Khoshnood K, Holford TR, Schuchat A: Declining incidence of invasive Streptococcus pneumoniae infections among persons with AIDS in an era of highly active antiretroviral therapy, 1995–2000. J Infect Dis. 2005, 191 (12): 2038-2045. 10.1086/430356.CrossRefPubMed
18.
go back to reference Gordon SB, Kanyanda S, Walsh AL, Goddard K, Chaponda M, Atkinson V, Mulwafu W, Molyneux EM, Zijlstra EE, Molyneux ME, Graham SM: Poor potential coverage for 7-valent pneumococcal conjugate vaccine, Malawi. Emerg Infect Dis. 2003, 9 (6): 747-749.CrossRefPubMedPubMedCentral Gordon SB, Kanyanda S, Walsh AL, Goddard K, Chaponda M, Atkinson V, Mulwafu W, Molyneux EM, Zijlstra EE, Molyneux ME, Graham SM: Poor potential coverage for 7-valent pneumococcal conjugate vaccine, Malawi. Emerg Infect Dis. 2003, 9 (6): 747-749.CrossRefPubMedPubMedCentral
19.
go back to reference Gordon MA, Graham SM, Walsh AL, Wilson L, Phiri A, Molyneux E, Zijlstra EE, Heyderman RS, Hart CA, Molyneux ME: Epidemics of invasive Salmonella enterica serovar enteritidis and S. enterica Serovar typhimurium infection associated with multidrug resistance among adults and children in Malawi. Clin Infect Dis. 2008, 46 (7): 963-969. 10.1086/529146.CrossRefPubMed Gordon MA, Graham SM, Walsh AL, Wilson L, Phiri A, Molyneux E, Zijlstra EE, Heyderman RS, Hart CA, Molyneux ME: Epidemics of invasive Salmonella enterica serovar enteritidis and S. enterica Serovar typhimurium infection associated with multidrug resistance among adults and children in Malawi. Clin Infect Dis. 2008, 46 (7): 963-969. 10.1086/529146.CrossRefPubMed
20.
go back to reference Arpi M, Bentzon MW, Jensen J, Frederiksen W: Importance of blood volume cultured in the detection of bacteremia. Eur J Clin Microbiol Infect Dis. 1989, 8 (9): 838-842. 10.1007/BF02185857.CrossRefPubMed Arpi M, Bentzon MW, Jensen J, Frederiksen W: Importance of blood volume cultured in the detection of bacteremia. Eur J Clin Microbiol Infect Dis. 1989, 8 (9): 838-842. 10.1007/BF02185857.CrossRefPubMed
21.
go back to reference Archibald LK, Dobbie H, Kazembe P, Nwanyanwu O, McKnight C, Byrne T, Addison RM, Bell M, Reller LB, Jarvis WR: Utility of paired BACTEC MYCO/F LYTIC blood culture vials for detection of bacteremia, mycobacteremia, and fungemia. J Clin Microbiol. 2001, 39 (5): 1960-1962. 10.1128/JCM.39.5.1960-1962.2001.CrossRefPubMedPubMedCentral Archibald LK, Dobbie H, Kazembe P, Nwanyanwu O, McKnight C, Byrne T, Addison RM, Bell M, Reller LB, Jarvis WR: Utility of paired BACTEC MYCO/F LYTIC blood culture vials for detection of bacteremia, mycobacteremia, and fungemia. J Clin Microbiol. 2001, 39 (5): 1960-1962. 10.1128/JCM.39.5.1960-1962.2001.CrossRefPubMedPubMedCentral
22.
go back to reference Gordon MA, Banda HT, Gondwe M, Gordon SB, Boeree MJ, Walsh AL, Corkill JE, Hart CA, Gilks CF, Molyneux ME: Non-typhoidal salmonella bacteraemia among HIV-infected Malawian adults: high mortality and frequent recrudescence. AIDS. 2002, 16 (12): 1633-1641. 10.1097/00002030-200208160-00009.CrossRefPubMed Gordon MA, Banda HT, Gondwe M, Gordon SB, Boeree MJ, Walsh AL, Corkill JE, Hart CA, Gilks CF, Molyneux ME: Non-typhoidal salmonella bacteraemia among HIV-infected Malawian adults: high mortality and frequent recrudescence. AIDS. 2002, 16 (12): 1633-1641. 10.1097/00002030-200208160-00009.CrossRefPubMed
23.
go back to reference Weinstein MP, Mirrett S, Wilson ML, Reimer LG, Reller LB: Controlled evaluation of 5 versus 10 milliliters of blood cultured in aerobic BacT/Alert blood culture bottles. J Clin Microbiol. 1994, 32 (9): 2103-2106.PubMedPubMedCentral Weinstein MP, Mirrett S, Wilson ML, Reimer LG, Reller LB: Controlled evaluation of 5 versus 10 milliliters of blood cultured in aerobic BacT/Alert blood culture bottles. J Clin Microbiol. 1994, 32 (9): 2103-2106.PubMedPubMedCentral
24.
go back to reference Koulla-Shiro S, Kuaban C, Belec L: Acute community-acquired bacterial pneumonia in Human Immunodeficiency Virus (HIV) infected and non-HIV-infected adult patients in Cameroon: aetiology and outcome. Tuber Lung Dis. 1996, 77 (1): 47-51. 10.1016/S0962-8479(96)90075-1.CrossRefPubMed Koulla-Shiro S, Kuaban C, Belec L: Acute community-acquired bacterial pneumonia in Human Immunodeficiency Virus (HIV) infected and non-HIV-infected adult patients in Cameroon: aetiology and outcome. Tuber Lung Dis. 1996, 77 (1): 47-51. 10.1016/S0962-8479(96)90075-1.CrossRefPubMed
25.
go back to reference Janoff EN, Rubins JB: Invasive pneumococcal disease in the immunocompromised host. Microb Drug Resist. 1997, 3 (3): 215-232.CrossRefPubMed Janoff EN, Rubins JB: Invasive pneumococcal disease in the immunocompromised host. Microb Drug Resist. 1997, 3 (3): 215-232.CrossRefPubMed
Metadata
Title
Blood culture collection technique and pneumococcal surveillance in Malawi during the four year period 2003–2006: an observational study
Authors
Neema Mtunthama
Stephen B Gordon
Temwa Kusimbwe
Eduard E Zijlstra
Malcolm E Molyneux
Neil French
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2008
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-8-137

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