1887

Chapter 5 : The bioMérieux BacT/Alert: Automation at Last in the Black Box

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

The bioMérieux BacT/Alert: Automation at Last in the Black Box, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555819828/9781555819811_Chap05-1.gif /docserver/preview/fulltext/10.1128/9781555819828/9781555819811_Chap05-2.gif

Abstract:

This chapter introduces the BacT/Alert, the first automated blood culture system, and its descendants. The first part of the chapter covers the historical context in which the system was developed and some of the key design considerations that were intended to close gaps in blood culture practice in the early 1990s. The second part of the chapter outlines the evolution of the BacT/Alert culture media, their performance, and design changes to subsequent instruments in the BacT/Alert family tree.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 1
Figure 1

Bactec 460 schematic illustrating the complex gas flow, bottle piercing, and analysis of positivity versus the BacT/Alert. Reproduced from ( ), with permission.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 2
Figure 2

Original BacT/Alert media (aerobic at left and anaerobic at right) containing a disk of membrane with bound dye at their bases. Compare with the positive and negative modern emulsion bottles in Figure 3B . The bottle on the right is negative but is gassed with 2.5% CO, which, combined with a difference in equilibrium from being bound to a membrane, results in a greenish color relative to the bottle at left in Figure 3B . The bottle at left is positive; the increase in reflected red light from the instrument’s LEDs would be interpreted as growth. Image courtesy of bioMérieux, used with permission.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 3
Figure 3

An array of modern BacT/Alert bottles (left to right: SA, SN, FN Plus, FA Plus, PF Plus, and MP). A negative (left) and positive (right) bottle, demonstrating the dye emulsion medium and the color change detected by the BacT/Alert system. Image courtesy of bioMérieux, used with permission.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 4
Figure 4

Mechanism of detection of growth detection in the BacT/Alert from the original patent ( ). 1, vessel; 2, sensor; 3, culture medium; 4, light source; 5, photodetector; and associated electronics including 6, current source; 7, current to voltage converter; and 8, low-pass filter. BacT/Alert reflectance curves for blood with (red), blood without organisms (blue, demonstrating baseline drift), and an uninoculated bottle (yellow).

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 5
Figure 5

The first prototype BacT/Alert, one of two built at Durham, NC, during placement in the laboratory of Barth Reller at Duke. Left to right are James Turner (director of the Durham group), James DiGuiseppi, and Thurman Thorpe. Note the differences in the instrument compared with the production instrument in Fig. 6 . Doors evolved from clear plastic prone to light leakage and interference to clear/dark (but infrared transparent) in initial production, then opaque doors.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 6
Figure 6

Larry Pope (manager of the instrument development group at Organon Teknika, where the production instrument was designed and manufactured), Thurman Thorpe, and James DiGuiseppi at the American Society for Microbiology general meeting, New Orleans, 1989, with a production model of the BacT/Alert. This instrument was produced for more than 10 years before it was succeeded by the BacT/Alert 3D system.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 7
Figure 7

BacT/Alert 3D system in modular form with touchscreen and integrated bar coder and the standalone BacT/Alert/3D 60 system . Image used with permission from bioMérieux.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 8
Figure 8

The BacT/Alert VIRTUO system in dual-unit format. The touchscreen at upper left can be used to automatically unload positive bottles (yellow “button” at upper right of screen), which are automatically deposited in the two slots at middle right. Bottles are robotically accessioned in groups of up to 40 at a time (center), and placed in internal racks by a robotic arm , allowing the bottles to be rocked . Negative bottles are automatically removed and placed in a waste receptacle at the bottom of each unit. Image used with permission from bioMérieux.

Citation: Ford B, Kallstrom G. 2017. The bioMérieux BacT/Alert: Automation at Last in the Black Box, p 85-111. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555819828.chap5
1. Ward KM,, Lehmann CA,, Leiken AM. 1993. Clinical Laboratory Instrumentation and Automation: Principles, Applications, and Selection. Saunders, Philadelphia, PA.
2. Lequin RM. 2005. Enzyme immunoassay (EIA)/enzyme-linked immunosorbent assay (ELISA). Clin Chem 51:24152418.
3. Hardy DJ,, Hulbert BB,, Migneault PC. 1992. Time to detection of positive BacT/Alert blood cultures and lack of need for routine subculture of 5- to 7-day negative cultures. J Clin Microbiol 30:27432745.
4. Organon Teknika v Becton Dickinson. United States Courts Archive. https://www.unitedstatescourts.org/federal/ncmd/15175/. Accessed 22 December 2016.
5. Thorpe TC,, Wilson ML,, Turner JE,, DiGuiseppi JL,, Willert M,, Mirrett S,, Reller LB. 1990. BacT/Alert: an automated colorimetric microbial detection system. J Clin Microbiol 28:16081612.
6. Wilson ML,, Weinstein MP,, Reller LB. 1994. Automated blood culture systems. Clin Lab Med 14:149169.
7. Altun O,, Almuhayawi M,, Lüthje P,, Taha R,, Ullberg M,, Özenci V. 2016. Controlled evaluation of the new BacT/Alert Virtuo blood culture system for detection and time to detection of bacteria and yeasts. J Clin Microbiol 54:11481151.
8. Brecher ME,, Means N,, Jere CS,, Heath D,, Rothenberg S,, Stutzman LC. 2001. Evaluation of an automated culture system for detecting bacterial contamination of platelets: an analysis with 15 contaminating organisms. Transfusion 41:477482.
9. Munksgaard L,, Albjerg L,, Lillevang ST,, Gahrn-Hansen B,, Georgsen J. 2004. Detection of bacterial contamination of platelet components: six years’ experience with the BacT/ALERT system. Transfusion 44:11661173.
10. Schlenke P. 2014. Pathogen inactivation technologies for cellular blood components: an update. Transfus Med Hemother 41:309325.
11. Lovern D,, Katzin B,, Johnson K,, Broadwell D,, Miller E,, Gates A,, Deol P,, Doing K,, van Belkum A,, Marshall C,, Mathias E,, Dunne WM Jr. 2016. Antimicrobial binding and growth kinetics in BacT/ALERT® FA Plus and BACTEC® Aerobic/F Plus blood culture media. Eur J Clin Microbiol Infect Dis 35:20332036.
12. Bourbeau P,, Riley J,, Heiter BJ,, Master R,, Young C,, Pierson C. 1998. Use of the BacT/Alert blood culture system for culture of sterile body fluids other than blood. J Clin Microbiol 36:32733277.
13. Simor AE,, Scythes K,, Meaney H,, Louie M. 2000. Evaluation of the BacT/Alert microbial detection system with FAN aerobic and FAN anaerobic bottles for culturing normally sterile body fluids other than blood. Diagn Microbiol Infect Dis 37:59.
14. Høst B,, Schumacher H,, Prag J,, Arpi M. 2000. Isolation of Kingella kingae from synovial fluids using four commercial blood culture bottles. Eur J Clin Microbiol Infect Dis 19:608611.
15. Bugno A,, Lira RS,, Oliveira WA,, Almodovar AAB,, Saes DPS,, Pinto TJ,, Bugno A,, Lira RS,, Oliveira WA,, Almodovar AAB,, Saes DPS,, de Jesus Andreoli Pinto T. 2015. Application of the BacT/ALERTR 3D system for sterility testing of injectable products. Braz J Microbiol 46:743747.
16. Parveen S,, Kaur S,, David SAW,, Kenney JL,, McCormick WM,, Gupta RK. 2011. Evaluation of growth based rapid microbiological methods for sterility testing of vaccines and other biological products. Vaccine 29:80128023.
17. Marais E,, Stewart R,, Dusé AG,, Rosekilly IC,, de Jong G,, Aithma N. 2004. Candida parapsilosis detected in TPN using the BacT/Alert system and characterized by randomly amplified polymorphic DNA. J Hosp Infect 56:291296.
18. Perez KK,, Olsen RJ,, Musick WL,, Cernoch PL,, Davis JR,, Land GA,, Peterson LE,, Musser JM. 6 December 2012. Integrating rapid pathogen identification and antimicrobial stewardship significantly decreases hospital costs. Arch Pathol Lab Med 137:12471254. doi:10.5858/arpa.2012-0651-OA.
19. Salimnia H,, Fairfax MR,, Lephart PR,, Schreckenberger P,, DesJarlais SM,, Johnson JK,, Robinson G,, Carroll KC,, Greer A,, Morgan M,, Chan R,, Loeffelholz M,, Valencia-Shelton F,, Jenkins S,, Schuetz AN,, Daly JA,, Barney T,, Hemmert A,, Kanack KJ. 2016. Evaluation of the FilmArray Blood culture identification panel: results of a multicenter controlled trial. J Clin Microbiol 54:687698.
20. Wojewoda CM,, Sercia L,, Navas M,, Tuohy M,, Wilson D,, Hall GS,, Procop GW,, Richter SS. 2013. Evaluation of the Verigene Gram-positive blood culture nucleic acid test for rapid detection of bacteria and resistance determinants. J Clin Microbiol 51:20722076.
21. Oliveira K,, Procop GW,, Wilson D,, Coull J,, Stender H. 2002. Rapid identification of Staphylococcus aureus directly from blood cultures by fluorescence in situ hybridization with peptide nucleic acid probes. J Clin Microbiol 40:247251.
22. Wolk DM,, Struelens MJ,, Pancholi P,, Davis T,, Della-Latta P,, Fuller D,, Picton E,, Dickenson R,, Denis O,, Johnson D,, Chapin K. 2009. Rapid detection of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in wound specimens and blood cultures: multicenter preclinical evaluation of the Cepheid Xpert MRSA/SA skin and soft tissue and blood culture assays. J Clin Microbiol 47:823826.
23. Hyman JM,, Walsh JD,, Ronsick C,, Wilson M,, Hazen KC,, Borzhemskaya L,, Link J,, Clay B,, Ullery M,, Sanchez-Illan M,, Rothenberg S,, Robinson R,, van Belkum A,, Dunne WM Jr. 2016. Evaluation of a fully automated research prototype for the immediate identification of microorganisms from positive blood cultures under clinical conditions. MBio 7:e00491-16. doi:10.1128/mBio.00491-16.
24. Krisher KK,, Whyburn DR,, Koepnick FE. 1993. Comparison of the BacT/Alert pediatric blood culture system, Pedi-BacT, with conventional culture using the 20-milliliter Becton-Dickinson supplemented peptone broth tube. J Clin Microbiol 31:793797.
25. Weinstein MP,, Mirrett S,, Reimer LG,, Wilson ML,, Smith-Elekes S,, Chuard CR,, Joho KL,, Reller LB. 1995. Controlled evaluation of BacT/Alert standard aerobic and FAN aerobic blood culture bottles for detection of bacteremia and fungemia. J Clin Microbiol 33:978981.
26. Mirrett S,, Joyce MJ,, Reller LB. 2005. Validation of performance of plastic versus glass bottles for culturing anaerobes from blood in BacT/ALERT SN medium. J Clin Microbiol 43:61506151.
27. Petti CA,, Mirrett S,, Woods CW,, Reller LB. 2005. Controlled clinical comparison of plastic and glass bottles of BacT/ALERT FA medium for culturing organisms from blood of adult patients. J Clin Microbiol 43:19601962.
28. Petti CA,, Mirrett S,, Woods CW,, Reller LB. 2005. Controlled clinical comparison of plastic versus glass bottles of BacT/ALERT PF medium for culturing blood from children. J Clin Microbiol 43:445447.
29. Mirrett S,, Everts RJ,, Reller LB. 2001. Controlled comparison of original vented aerobic fan medium with new nonvented BacT/ALERT FA medium for culturing blood. J Clin Microbiol 39:20982101.
30. Food and Drug Administration Inspections. 23 August 2012. bioMérieux, Inc. Compliance, Enforcement, and Criminal Investigations Warning Letter. http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2012/ucm318709.htm.
31. Flayhart D,, Borek AP,, Wakefield T,, Dick J,, Carroll KC. 2007. Comparison of BACTEC PLUS blood culture media to BacT/Alert FA blood culture media for detection of bacterial pathogens in samples containing therapeutic levels of antibiotics. J Clin Microbiol 45:816821.
32. Smith JA,, Bryce EA,, Ngui-Yen JH,, Roberts FJ. 1995. Comparison of BACTEC 9240 and BacT/Alert blood culture systems in an adult hospital. J Clin Microbiol 33:19051908.
33. Zadroga R,, Williams DN,, Gottschall R,, Hanson K,, Nordberg V,, Deike M,, Kuskowski M,, Carlson L,, Nicolau DP,, Sutherland C,, Hansen GT. 2013. Comparison of 2 blood culture media shows significant differences in bacterial recovery for patients on antimicrobial therapy. Clin Infect Dis 56:790797.
34. US Food and Drug Administration. 2013. 510(k) Premarket Notification: BACT/ALERT FA Plus Culture Bottle. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K121461
35. bioMérieux, Inc. 2013. BacT/ALERT FA Plus package insert (English), revision 9305048 C, 2013-04. bioMérieux, Inc., Marcy-l’Étoile, France.
36. Mitteregger D,, Barousch W,, Nehr M,, Kundi M,, Zeitlinger M,, Makristathis A,, Hirschl AM. 2013. Neutralization of antimicrobial substances in new BacT/Alert FA and FN Plus blood culture bottles. J Clin Microbiol 51:15341540.
37. Lee D-H,, Kim SC,, Bae I-G,, Koh E-H,, Kim S. 2013. Clinical evaluation of BacT/Alert FA plus and FN plus bottles compared with standard bottles. J Clin Microbiol 51:41504155.
38. Sullivan KV,, Turner NN,, Lancaster DP,, Shah AR,, Chandler LJ,, Friedman DF,, Blecker-Shelly DL. 2013. Superior sensitivity and decreased time to detection with the Bactec Peds Plus/F system compared to the BacT/Alert Pediatric FAN blood culture system. J Clin Microbiol 51:40834086.
39. Nutman A,, Fisher Even-Tsur S,, Shapiro G,, Braun T,, Schwartz D,, Carmeli Y. 2016. Time to detection with BacT/Alert FA Plus compared to BacT/Alert FA blood culture media. Eur J Clin Microbiol Infect Dis 35:14691473.
40. Kirn TJ,, Mirrett S,, Reller LB,, Weinstein MP. 2014. Controlled clinical comparison of BacT/alert FA plus and FN plus blood culture media with BacT/alert FA and FN blood culture media. J Clin Microbiol 52:839843.
41. Wilson ML,, Weinstein MP,, Reimer LG,, Mirrett S,, Reller LB. 1992. Controlled comparison of the BacT/Alert and BACTEC 660/730 nonradiometric blood culture systems. J Clin Microbiol 30:323329.
42. Pohlman JK,, Kirkley BA,, Easley KA,, Basille BA,, Washington JA. 1995. Controlled clinical evaluation of BACTEC Plus Aerobic/F and BacT/Alert Aerobic FAN bottles for detection of bloodstream infections. J Clin Microbiol 33:28562858.
43. Zwadyk P Jr,, Pierson CL,, Young C. 1994. Comparison of Difco ESP and Organon Teknika BacT/Alert continuous-monitoring blood culture systems. J Clin Microbiol 32:12731279.
44. Mirrett S,, Hanson KE,, Reller LB. 2007. Controlled clinical comparison of VersaTREK and BacT/ALERT blood culture systems. J Clin Microbiol 45:299302.
45. Doern GV,, Barton A,, Rao S. 1998. Controlled comparative evaluation of BacT/Alert FAN and ESP 80A aerobic media as means for detecting bacteremia and fungemia. J Clin Microbiol 36:26862689.
46. Fiori B,, D’Inzeo T,, Di Florio V,, De Maio F,, De Angelis G,, Giaquinto A,, Campana L,, Tanzarella E,, Tumbarello M,, Antonelli M,, Sanguinetti M,, Spanu T. 2014. Performance of two resin-containing blood culture media in detection of bloodstream infections and in direct matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) broth assays for isolate identification: clinical comparison of the BacT/Alert Plus and Bactec Plus systems. J Clin Microbiol 52:35583567.
47. Turner JE,, Thorpe TC,, Di Guiseppi JL,, Driscoll RC. 1990. Device for detecting microorganisms. US4945060 A. https://www.google.com/patents/US4945060

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error