CLINICAL ASPECTS AMT, v. II, no. 1, 2014, p. 188 COMPARATIVE STUDY OF MONITORING RESULTS OBTAINED THROUGH TWO HEMOCULTURE SYSTEMS, IN A GROUP OF PATIENTS WITH HEPATIC TRANSPLANT JENI LAURA VLAD 1 , MIHAELA TEODOR 2 , DOINA HREHORET 3 , MIRCEA IOAN POPA 4 , IRINEL POPESCU 5 1,2 “Fundeni” Clinical Institute 3,5 Centre of General Surgery and Liver Transplant, “Fundeni” Clinical Institute, 4 ”Carol Davila” University of Medicine and Pharmacy Keywords: bacteriological screening, blood culture, liver transplant Abstract: Introduction. Blood borne infections have a decisive role in the evolution of the liver transplant patient. Detecting these infections remains an absolute priority. Objectives. To compare the ability of two automated microbiological screening systems (VersaTREK versus BACTEC 9050) in detecting the bacterial and fungal etiology of hemocultures in the curable-phases of infection in liver transplant patients, in order to apply the timely and guided antibiotic and antifungal treatment. Material and method. The microbiological study was performed on 60 liver transplant patients (38 men and 22 women) at the “Dan Setlacec” General Surgery and Liver Transplantation Centre from Fundeni Clinical Institute. This study was performed from February to November 2013, in patients with at least 2-3 episodes of transient bacteremia and / or in postoperative sepsis, with 1 to 30 CFU / ml blood the limit of detection. 480 blood cultures from both systems were collected, 240 aerobic and 240 anaerobic. VersaTREK bottles (Redox 1/40 ml, Redox 2/40 ml) were compared with aerobic and anaerobic standard BACTEC/F. By comparing these systems, we detected isolated bacteria and fungi from positive blood cultures. Results. The time to growth detection from the moment of incubation was 18 hours for all organisms on the VersaTREK system, with detection sensitivity of fewer than 20 CFU / ml, as compared to the BACTEC system where growth was detected at 24 hours. We isolated a percent of 30% Gram- negative bacilli (non-fermenters and fermenters), 21.6% MRSA and 6.6% Candida albicans. False positive results were detected – 16.6% for VersaTREK and 25% on BACTEC. Contaminations were particularly present when blood was drawn from an indwelling catheter and less often when a percutaneous venipuncture was performed. For the VersaTREK system, an inoculum of 0.1 ml yielded detection and isolation of germs after only 3 hours after incubation. Conclusions. Both systems were effective in detection of bacteria and fungi in liver transplant patients, but in the case of the VersaTREK system germs were detected and isolated from 0.1 ml inoculum at >3 hours from incubation. Cuvinte cheie: screening bacteriologic, hemocultură, transplant hepatic Rezumat: Introducere: Infecțiile transmise pe cale sanguină au o importanță decisivă în evoluția pacientului cu transplant hepatic. Diagnosticarea acestor infecții rămâne o prioritate absolută. Obiectiv: Depistarea în faze curabile a etiologiei bacteriene şi fungice urmărită comparativ cu ajutorul a două sisteme automate de screening microbiologic (VersaTREK versus BACTEC 9050) la pacientul transplantat hepatic, în scopul aplicării tratamentului antibiotic şi antifungic adecvat cât mai rapid. Material şi metodă: Studiul microbiologic s-a efectuat pe un lot de 60 de pacienţi (38 bărbaţi şi 22 femei) transplantaţi hepatic în Centrul de Chirurgie Generală şi Transplant Hepatic “Dan Setlacec” din Institutul Clinic Fundeni. Acesta s-a efectuat în perioada februarie-noiembrie 2013 la pacienţi care au prezentat cel puţin 2-3 episoade de bacteriemii tranzitorii în cadrul sepsisului postoperator cu o limită de detecţie de 1-30 UFC / ml sânge. S-au recoltat 480 prelevate - hemoculturi din ambele sisteme, aerobe (240) şi anaerobe (240). Flacoanele VersaTREK (Redox 1/40ml, Redox 2/40 ml) au fost comparate cu standardul aerob şi anaerob BACTEC/F. S-au identificat bacteriile şi fungii izolaţi din hemoculturi pozitive. Rezultate: Timpul de creştere-pozitivare din momentul incubării la sistemul VersaTREK a detectat o creştere la <18 ore pentru toate microorganismele, cu o sensibilitate de detecţie de sub <20 UFC / ml faţă de sistemul BACTEC care a detectat o creştere la >24 ore. S-a evidenţiat un procent de 30% bacili Gram negativi nefermentativi şi fermentativi, 21,6% MRSA şi 6,6% Candida albicans. S-au obţinut rezultate fals pozitive – contaminări evidenţiate în special în cazurile în care nu s-a folosit metoda percutanată de venopuncţie periferică, recoltarea fiind practicată pe cateter într-un procent de 16,6% la sistemul VersaTREK şi 25% la sistemul BACTEC. Concluzii: Ambele sisteme au fost eficiente în detecţia bacteriilor şi fungilor la pacientul transplantat hepatic, dar în cazul sistemului VersaTREK din inoculul de 0,1 ml s-au detectat şi izolat germeni la >3 ore de la incubare. 1 Corresponding author: Jeni Laura Vlad, Şoseaua Fundeni, Nr. 258, Etaj 2, Sector 2, Bucureşti, E-mail: laurettajeni@yahoo.com Article received on 13.01.2014 and accepted for publication on 20.01.2014 ACTA MEDICA TRANSILVANICA March 2014;2(1):188-192 INTRODUCTION Infections transmitted through blood and blood products have a central role in the evolution as well as in infectious exacerbations that appear in liver transplant patient. These lead to a decrease in the quality of life. Detecting the