Examples of non-fermenting organisms:
(1) Pseudomonas aeruginosa
(2) Stenotrophomonas maltophilia
(3) Acinetobacter baumannii
Factors contributing to a failure to detect non-fermenting bacteria:
(1) failure to perform subculture of the blood culture media onto agar plates
(2) use of a high inoculum of bacteria
(3) how the bottles are handled prior to loading the automated analyzer, especially pre-incubation for several hours at 36°C
Recommendations to enhance detection of non-fermenting Gram-negative bacteria:
(1) Subculture the blood culture bottles prior to placement in the automated blood culture analyzer and then at regular intervals including just prior discarding of the bottles.
(2) Properly handle the blood culture bottles:
(2a) If possible, load the bottle into the analyzer soon after the specimen has been collected.
(2b) If a delay in loading occurs, preincubate the bottles at room temperature (not 36°C).