BD BACTEC / BACT/ALERT (AUTOMATION)

• BD BACTECTM/BACT/ALERTTM (AUTOMATION)

  • BacT/AlertTM uses a colorimetric sensor
  • BACTECTM uses a fluorimetric sensor
  • Both detect CO2 changes
  • Very similar workflow
  • Culture bottles are commonly used in the clinical laboratory. 
  • Almost all tertiary hospitals have either BACTEC or BACT/ALERT for initial screening.
• MECHANISM:

  • 1.Organism metabolic activity releases CO2
  • In a positive sample, there is an organism thriving inside that produces CO2.
  • 2. Which reacts with dye in vial sensor
  • The CO2 will react to the dye at the bottom of the sensor located at the end of the bottle.
  • The bottle is incubated and placed on a machine. 
  • 3. LED activates fluorescent material in the sensor. Fluorescence is modulated by dye in the sensor.
  • At the bottom of the machine, there is a LED light that emits a color to activate the dye.
• MECHANISM

  • 4. Photo detector reads fluorescence.
  • The resulting fluorescence omitted is detected by the photo detector.
  • 5. Raw data from the detector is analyzed by a row board.
  • The photo detector will send the reading to a raw board.
  • 6. And positivity analysis is performed.
• MECHANISM:

  7. Positive vial is announced by audible alert, on screen indicators, and the Positive Vial system indicator.

  • There is an alarm sound and the machine will flash color red for a positive result.
  • This indicates that there is a positive sample in the incubator.
  • However, the BACTEC or BACT/ALERT cannot identify specific strains or species of organism. They merely indicate the presence of a microorganism without specifying its type.
  • It is not specific towards a certain group.

  As long as the microorganism metabolizes and releases CO2, the CO2 indicator will go positive.
• BACT/ALERT Blood Culture Collection: Needle and Syringe Draw Method

  • Blood Culture Preparation
  • A properly collected blood culture sample, free of contaminants, help ensure accurate results that will improve patient outcomes
• BACT/ALERT Blood Culture Collection: Needle and Syringe Draw Method

  • Important blood culture bottle information
  • Bottle lot number
  • Expiration date
  • Fill to mark
  • Barcode
  • Window for checking the level of blood
• BACT/ALERT Blood Culture Collection: Needle and Syringe Draw Method

  • Ensure culture bottles are within the expiration date.
  • Examine bottles for visible signs of damage, deterioration, leakage.
  • Do not use a bottle which contains medium exhibiting turbidity.
  • Medium exhibiting turbidity - a yellow sensor or any other visible defects (may be a sign of contamination).
• BACT/ALERT Blood Culture Collection: Needle and Syringe Draw Method

  • Procedure:

  1. Wash hands with soap and water or apply alcohol.
  2. Prepare collection materials in a clean, protected area to minimize contamination.
  3. Before starting the collection, confirm patient identity.
  4. Remove the flip caps in the blood culture bottles and disinfect with approved disinfectant.
  5. Use a fresh swab/applicator for each bottle.
  6. Remove swab/applicator and allow bottle tops to dry completely.
• BACT/ALERT Blood Culture Collection: Needle and Syringe Draw Method

  PROCEDURE 7. Place a disposable underpad under the patient's arm (the arm is the recommended site for blood culture).

  8. Locate the vein and apply disposable tourniquet.

  9. Palpate to locate vein.

  10. Wash hands with soap and water/alcohol.

  11. Apply well-fitting non-sterile examination gloves.

  12. Disinfect the chosen venipuncture site.

  13. Scrub the venipuncture site according to your facility’s policy (30 seconds or more).
• • Blood Culture Collection with Needle and Syringe:
  • 1.Assemble syringe and needle (do not re-palpate the prepared vein before inserting the needle).
  • 2. Enter the vein swiftly.
  • Blood appearing in the syringe confirms a successful venipuncture.
  • 3. Release the tourniquet as soon as blood starts to flow and always before it has been in pace for 2 mins or more.
  • For adult patients - 20 ml of blood.
  • For pediatric patients, a special pediatric aerobic bottle may be used and inoculated with up to 4 ml of blood.
  • 4. Remove the needle from the vein.
• • Blood Culture Collection with Needle and Syringe:
  • 5. Cover the puncture site with dressing and apply pressure.
  • 6. Discard the needle .
  • 7. Attach a safety transfer device to the syringe (inoculate the anaerobic bottle first).
  • 8. Use the fill tube mark to accurately gauge the sample volume.
  • 10 ml per bottle for adults
  • For pediatric patients, you may choose to use a unique pediatric aerobic bottle.
• • Blood Culture Collection with Needle and Syringe:
  • 9. Once the anaerobic bottle has been inoculated, remove the adapter cap and repeat for the aerobic bottle.
  • If other blood tests are required, always collect blood culture first.
  • 10. Mix blood culture bottles, invert 3-5 times.
  • 11. Discard the syringe and adapter in a sharps container and dispose of other materials.
  • 12. To properly label the bottle, use the dedicated area on the bottle.
• • Blood Culture Collection with Needle and Syringe:
  • 13. Place the barcode labels vertically so that the orientation is the same as the bottle barcode.
  • Ensure that any additional labels do not cover the bottle barcode.
  • 14. Place bottles and blood collection tubes in a biohazardous plastic bag and request form in an outside compartment.
  • 15. Transfer the inoculated culture bottles promptly to the testing laboratory.
• • 3 Important Points to Remember in regard to Blood Culture Collection
  • Proper disinfection is crucial to ensuring a contamination free culture.
  • Sufficient blood volume will help ensure optimal organism detection.
  • Transfer promptly the inoculated bottles to the testing laboratory.