RT Journal Article SR Electronic(1) A1 Peeters, Marjan A1 Ombelet, Sien A1 Chung, Panha A1 Tsoumanis, Achilleas A1 Lim, Kruy A1 Long, Leng A1 De Smet, Birgit A1 Kham, Chun A1 Teav, Syna A1 Vlieghe, Erika A1 Phe, Thong A1 Jacobs, JanYR 2019 T1 Slow growth of Burkholderia pseudomallei compared to other pathogens in an adapted blood culture system in Phnom Penh, Cambodia JF Journal of Medical Microbiology, VO 68 IS 8 SP 1159 OP 1166 DO https://doi.org/10.1099/jmm.0.001011 PB Microbiology Society, SN 1473-5644, AB Purpose. Burkholderia pseudomallei is a key pathogen causing bloodstream infections at Sihanouk Hospital Center of Hope, Phnom Penh, Cambodia. Here, visual instead of automated detection of growth of commercial blood culture bottles is done. The present study assessed the performance of this system. Methodology. Blood culture sets, consisting of paired adult aerobic and anaerobic bottles (bioMérieux, FA FAN 259791 and FN FAN 252793) were incubated in a standard incubator for 7 days after reception. Each day, the bottle growth indicator was visually inspected for colour change indicating growth. Blind subculture was performed from the aerobic bottle at day 3. Results. From 2010 to 2015, 11  671 sets representing 10  389 suspected bloodstream infection episodes were documented. In 1058 (10.2  %) episodes, pathogens grew; they comprised Escherichia coli (31.7 %), Salmonella Paratyphi A (13.9 %), B. pseudomallei (8.5 %), Staphylococcus aureus (7.8 %) and Klebsiella pneumoniae (7.0 %). Blind subculture yielded 72 (4.1  %) pathogens, mostly (55/72, 76.4 %) B. pseudomallei . Cumulative proportions of growth at day 2 were as follows: E. coli : 85.0 %, Salmonella Paratyphi A: 85.0 %, K. pneumoniae : 76.3  % and S. aureus : 52.2  %; for B. pseudomallei , this was only 4.0  %, which increased to 70.1  % (70/99) at day 4 mainly by detection on blind subculture (55/99). Compared to the anaerobic bottles, aerobic bottles had a higher yield and a shorter time-to-detection, particularly for B. pseudomallei . Conclusions. Visual inspection for growth of commercial blood culture bottles in a low-resource setting provided satisfactory yield and time-to-detection. However, B. pseudomallei grew slowly and was mainly detected by blind subculture. The aerobic bottle outperformed the anaerobic bottle., UL https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.001011