Effect of antimicrobials on blood cultures in endocarditis

To study the effect of antimicrobials on bacterial growth in blood cultures, we used both simulated blood cultures and cultures obtained from rabbits with experimental endocarditis. Four strains of bacteria were incubated individually with six antimicrobials in nine blood culture media. Positivity rates varied with the ratio of the antimicrobial concentration to the MIC of the organism: 161 of 162 cultures (99%) were positive when the ratio was less than 1/10; 52 of 108 (48%) were positive when the ratio was between 1/10 and one; and none of 54 were positive when the ratio was greater than one. Endocarditis was produced in 28 rabbits with either E. coli, P. aeruginosa, S. aureus, or viridans streptococcus. Following a single dose of an antimicrobial, blood was taken for culture in eight media. Only for viridans streptococcus did recovery rates vary significantly in different media. Recovery rates for this organism in two supplemented peptone broths (78% and 89%) and in hypertonic supplemented peptone (78%) were each higher than in thioglycolate (22%), Columbia (22%), Bactec aerobic and anaerobic (11%), and trypticase soy broths (11%) (p less than 0.05 for each pair). Growth of bacteria in blood cultures containing antimicrobials depended on the ratio of the antimicrobial concentration to the MIC and, for viridans streptococcus, the blood culture medium.