Sterility testing of HPC

[kate murphy]

I'd like to know what other facilites are doing for sterility testing of HPCs (auto's only).

Direct plating? Gram stain? Blood Culture - (what platform)?

What is done when any result is postive?

Requirements for process control include sterility. We have done blood cultures on Vitek instrument for 12 years. A new med director in micro is not allowing the use of the Vitek, as there is no literature supporting this use of the Vitek.

Anyone willing to share what they do?

[bmarotto]

Kate,

Our micro lab does direct plating on blood, chocolate, and anaerobic blood agar for bacterial culture. For fungal culture they use Chocolate agar, Brain Heart Infusion agar with Blood, and Inhibitory Mold agar (IMA). They hold the bacterial plates for 7 days, examining daily. The fungal plates are held for 28 days, examing daily for the first 7 days then weekly until day 28. FACT does not specify fungal cultures but when we contacted them about it a few months back (we were considering discontinuing the fungal culture) they said fungal cultures will probably be required in the next standards.

If they should get a postive, they work it up as they would any other positive. So far, they have never identified anything that our docs considered significant. Most often, they find something that grows a few colonies on one plate only. They consider this to be a lab contaminant. To be safe, we thaw a nunc vial aliquot and they repeat the culture. We have never had a positive on repeat.

[dpflanz]

We do sterility testing on all HPC's (autos only at our facility) using the media that our testing laboatory supplies us with: BaT/Alert media; SA, for an aerobic 5 day culture and MB, for a fungal 42 day culture. They are loaded into the automated blood culture machine at the core reference laboratory.

If they get a positive, which is an extremely rare situation, it is worked up per the micro SOP. We also use the nunc aliquot to double check any positive cultures.