[21286869]
Becton dickinson enriched thioglycollate medium was used at hospital, to disperse tissue for gram stain and to aliquote samples to various medias. Gram stains of multiple sequential tissue specimens were reported as positive for gram positive cocci. No growth was ever detected. Because not all bacteria seen on gram stain from clinical specimens grew due to a variety of circumstances including the possibility of fastidious organisms or patients receiving antibiotics prior to specimen collection, this problem was not immediately identified. Some patients had central venous catheters placed to facilitate a anticipated long term antibiotic administration. Only after several patients with no clinical suspicion for infection were identified with clinical specimens described as having positive gram stains but negative cultures was the non inoculated thioglycollate medium gram stained and cultured. Non viable gram positive cocci was consistently detected from multiple lots of becton dickinson enriched thioglycollate medium. While the hospital stopped dispersing tissue specimens in thioglycollate medium for gram stain, the presence of non viable gram positive cocci remains a potentially significant issue. Nutrient broth inoculated with turbid fluid or tissue will appear cloudy. After incubation, this cloudy appearance necessitates evaluation to determine if bacteria are present. Non viable gram positive cocci in the broth leads to further clinical problems. Dates of use: 2008. Diagnosis or reason for use: rule out infection.
Patient Sequence No: 1, Text Type: D, B5