Comparative evaluation of BacT/ALERT PF Plus and PF pediatric blood culture bottles: A dual in vitro and clinical retrospective study.

PURPOSE: Prompt diagnosis of pediatric bloodstream infections (BSI) is challenged by low blood volumes and prior antibiotic use. This study systematically evaluated the performance of the new-generation BacT/ALERT PF Plus pediatric blood culture bottle against the standard PF bottle.

METHODS

This study combined in vitro verification using 16 common BSI pathogens to compare time to detection (TTD) and antibiotic neutralization, with a retrospective clinical study of 10,920 pediatric blood cultures from 2019 to 2024.

RESULTS

In vitro, PF Plus bottles reduced median TTD by 2.39 h (P < 0.05) and demonstrated superior neutralization of ampicillin and vancomycin. Clinically, the transition to PF Plus increased the overall positivity rate (1.97% to 2.27%), significantly reduced median TTD by 4.06 h (P < 0.05), and expanded the pathogen spectrum to include key organisms like Staphylococcus aureus and non-fermenting bacteria. Blood volume analysis suggested a potential optimal range of 5.1-6.0 mL, while maintaining reliable performance at suboptimal volumes (< 1.0 mL).

CONCLUSION

The PF Plus bottle offers faster detection, enhanced antibiotic neutralization, and improved pathogen recovery. Despite limitations inherent to retrospective designs, our data support PF Plus as an enhanced diagnostic tool and provide preliminary reference values for pediatric blood sample volumes.