{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T18:45:12Z","timestamp":1772649912322,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Continuous monitoring blood culture systems (CMBCSs) are revolutionary automated instruments that facilitate the rapid identification of pathogens in blood samples from patients with sepsis. However, with only a few CMBCSs being widely used as references, user dependency on these limited options has grown. In response, a new CMBCS was developed and compared with existing systems to evaluate microbial growth. Methods: HubCentra84 was compared to BacT\/Alert\u00ae 3D and BACTEC\u2122 FX. Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Bacteroides fragilis, and Candida albicans were selected as representative clinically infectious microorganisms. Colonies from pure cultures were diluted with 0.9% saline to create simulated sepsis specimens (SSSs). The SSSs were injected into dedicated culture bottles for each instrument. Thirty paired tests were performed for each strain. Results: Colony-forming units of the added SSSs were consistent according to bacteria, and all strains demonstrated robust growth in three CMBCSs. Time-to-positivity was uniformly observed according to the instruments used. The novel CMBCS detected the growth of the clinically significant bacteria S. aureus, S. pneumoniae, E. coli, and P. aeruginosa approximately 2 h faster than the other two systems. However, it was approximately 200 min slower for C. albicans and 3000 min for B. fragilis. Conclusions: The novel CMBCS demonstrates advantages in detecting the growth of common clinical bacteria. Although slow growth was detected for certain microorganisms, it successfully captured the growth of all tested microorganisms.<\/jats:p>","DOI":"10.3390\/diagnostics15040468","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T11:14:41Z","timestamp":1739531681000},"page":"468","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Performance Evaluation of Continuous Monitoring Blood Culture Systems Using Simulated Septic Specimen"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-6203","authenticated-orcid":false,"given":"Kwangjin","family":"Ahn","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju-si 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0706-167X","authenticated-orcid":false,"given":"Taesic","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Yonsei University Wonju College of Medicine, Wonju-si 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8666-7479","authenticated-orcid":false,"given":"Sangwon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju-si 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Min","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Medical Information, Yonsei University Wonju College of Medicine, Wonju-si 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2879-7870","authenticated-orcid":false,"given":"Young","family":"Uh","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju-si 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1097\/CCM.0000000000005054","article-title":"Identifying high-risk subphenotypes and associated harms from delayed antibiotic orders and delivery","volume":"49","author":"Han","year":"2021","journal-title":"Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1056\/NEJMoa1703058","article-title":"Time to treatment and mortality during mandated emergency care for sepsis","volume":"376","author":"Seymour","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/0196-4399(93)90051-N","article-title":"Historical evolution of automated blood culture systems","volume":"15","author":"Ryan","year":"1993","journal-title":"Clin. Microbiol. Newsl."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Menchinelli, G., Liotti, F.M., Fiori, B., Angelis, G.D., D\u2019Inzeo, T., Giordano, L., Posteraro, B., Sabbatucci, M., Sanguinetti, M., and Spanu, T. (2019). In vitro evaluation of BACT\/ALERT\u00ae VIRTUO\u00ae, BACT\/ALERT 3D\u00ae, and BACTEC\u2122 FX automated blood culture systems for detection of microbial pathogens using simulated human blood samples. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.02688"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Li, G., Sun, J., Pan, S., Li, W., Zhang, S., Wang, Y., Sun, X., Xu, H., and Ming, L. (2019). Comparison of the performance of three blood culture systems in a Chinese tertiary-care hospital. Front. Cell. Infect. Microbiol., 9.","DOI":"10.3389\/fcimb.2019.00285"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1128\/jcm.28.7.1608-1612.1990","article-title":"Bact\/Alert: An automated coloimetric microbial detection system","volume":"28","author":"Thorpe","year":"1990","journal-title":"J. Clin. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1128\/jcm.31.3.552-557.1993","article-title":"Multicenter clinical evaluation of a continuous monitoring blood culture system using fluorescent-sensor technology (BACTEC 9240)","volume":"31","author":"Nolte","year":"1993","journal-title":"J. Clin. Microbiol."},{"key":"ref_8","first-page":"229","article-title":"Controlled clinical comparison of VersaTREK and BacT\/ALERT blood culture systems","volume":"45","author":"Mirrett","year":"2006","journal-title":"J. Clin. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Hardy, L., Vermoesen, T., Genbrugge, E., Natale, A., Franquesa, C., Gleeson, B., Ferreyra, C., Dailey, P., and Jacobs, J. (2024). Affordable blood culture systems from China: In vitro evaluation for use in resource-limited settings. EBioMedicine, 101.","DOI":"10.1016\/j.ebiom.2024.105004"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ombelet, S., Natale, A., Ronat, J.B., Vandenberg, O., Jacobs, J., and Hardy, L. (2021). Considerations in evaluating equipment-free blood culture bottles: A short protocol for use in low-resource settings. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0267491"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ombelet, S., Barb\u00e9, B., Affolabi, D., Ronat, J.B., Lompo, P., Lunguya, O., Jacobs, J., and Hardy, L. (2019). Best practices of blood cultures in low- and middle-income countries. Front. Med., 6.","DOI":"10.3389\/fmed.2019.00131"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"58","DOI":"10.5145\/ACM.2014.17.2.58","article-title":"Factors influencing the false positive signals of continuous monitoring blood culture system","volume":"17","author":"Uh","year":"2014","journal-title":"Ann. Clin. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s10916-018-1046-y","article-title":"A new bacterial growth graph pattern analysis to improve positive predictive value of continuous monitoring blood culture system","volume":"42","author":"Ahn","year":"2018","journal-title":"J. Med. Syst."},{"key":"ref_14","unstructured":"Global Antimicrobial Resistance and Use Surveillance System (GLASS) (2025, January 03). Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report 2022, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240062702."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Kim, H., Park, J.S., Kim, D., Kim, H.J., Shin, J.H., Kim, Y.A., Uh, Y., Kim, S.H., Shin, J.H., and Jeong, S.H. (2024). Standardization of an antimicrobial resistance surveillance network through data management. Front. Cell. Infect. Microbiol., 14.","DOI":"10.3389\/fcimb.2024.1411145"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kim, D., Yoon, E.J., Hong, J.S., Choi, M.H., Kim, H.S., Kim, Y.R., Kim, Y.A., Uh, Y., Shin, K.S., and Shin, J.H. (2022). Major bloodstream infection-causing bacterial pathogens and their antimicrobial resistance in South Korea, 2017\u20132019: Phase I report from Kor-GLASS. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.799084"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1800047","DOI":"10.2807\/1560-7917.ES.2018.23.42.1800047","article-title":"Antimicrobial resistance of major clinical pathogens in South Korea, May 2016 to April 2017: First one-year report from Kor-GLASS","volume":"23","author":"Lee","year":"2018","journal-title":"Euro Surveill."},{"key":"ref_18","first-page":"131","article-title":"Bacteroides fragilis: A case study of bacteremia and septic arthritis","volume":"22","author":"Martin","year":"2009","journal-title":"Clin. Lab. Sci."},{"key":"ref_19","first-page":"293","article-title":"Resistance trends of Bacteroides fragilis group over an 8-year period, 1997\u20132004, in Korea","volume":"29","author":"Roh","year":"2009","journal-title":"Korean J. Lab. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"216","DOI":"10.3947\/ic.2009.41.4.216","article-title":"Recent trends of anaerobic bacteria isolated from clinical specimens and clinical characteristics of anaerobic bacteremia","volume":"41","author":"Park","year":"2009","journal-title":"Infect. Chemother."},{"key":"ref_21","unstructured":"Global Antimicrobial Resistance Surveillance System (GLASS) (2025, January 03). Early Implementation Protocol for the Inclusion of Candida spp., Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-WSI-AMR-2019.4."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Won, E.J., Choi, M.J., Jeong, S.H., Kim, D., Shin, K.S., Shin, J.H., Kim, Y.R., Kim, H.S., Kim, Y.A., and Uh, Y. (2022). Nationwide surveillance of antifungal resistance of Candida bloodstream isolates in South Korean Hospitals: Two year report from Kor-GLASS. J. Fungi, 8.","DOI":"10.3390\/jof8100996"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1001\/jama.1907.25320140022001f","article-title":"The nephelometer: An instrument for estimating the number of bacteria in suspensions used for calculating the opsonic index and for vaccines","volume":"14","author":"McFarland","year":"1907","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s00284-015-0801-2","article-title":"A comparative study of McFarland turbidity standars and the densimat photometer to determine bacterial cell density","volume":"70","author":"Zapata","year":"2015","journal-title":"Curr. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Reier-Nilsen, T., Farstad, T., Nakstad, B., Lauvrak, V., and Steinbakk, M. (2009). Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: A case control study. BMC Pediatr., 9.","DOI":"10.1186\/1471-2431-9-5"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1128\/CMR.3.3.269","article-title":"Quantitative aspects of septicemia","volume":"3","author":"Yagupsky","year":"1990","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/BF02877773","article-title":"Comparison of the BACTEC blood culture system versus conventional methods for culture of normally sterile body fluids","volume":"24","author":"Kaya","year":"2007","journal-title":"Adv. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3273","DOI":"10.1128\/JCM.36.11.3273-3277.1998","article-title":"Use of BacT\/Alert blood culture system for culture of sterile body fluids other than blood","volume":"36","author":"Bourbeau","year":"1998","journal-title":"J. Clin. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"829","DOI":"10.4103\/0972-5229.146331","article-title":"Evaluation of BACTEC\u2122 blood culture system for culture of normally sterile body fluids","volume":"18","author":"Udayan","year":"2014","journal-title":"Indian J. Crit. Care Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"23","DOI":"10.15263\/jlmqa.2015.37.1.23","article-title":"Evaluation of blood culture system for culture of body fluids","volume":"37","author":"Park","year":"2015","journal-title":"J. Lab. Med. Qual. Assur."},{"key":"ref_31","unstructured":"(2025, January 03). K121455\u2013510(k) Premarket Notification\u2013DA, Available online: https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf12\/K121455.pdf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1631\/jzus.B1500201","article-title":"0.9% saline is neither normal nor physiological","volume":"17","author":"Li","year":"2016","journal-title":"J. Zhejiang Univ. Sci. B."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Chen, G.Y., Chai, T.Q., Wang, J.L., and Yang, F.Q. (2023). Recent advances in the colorimetric and fluorescence analysis of bioactive small-molecule compounds based on the enzyme-like activity of nanomaterials. J. Pham. Biomed. Anal., 236.","DOI":"10.1016\/j.jpba.2023.115695"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Celik, C., Kalin, G., Cetinkaya, Z., Ildiz, N., and Ocsoy, I. (2023). Recent advances in colorimetric tests for the detection of infectious diseases and antimicrobial resistance. Diagnostics, 13.","DOI":"10.3390\/diagnostics13142427"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Tomazin, R., Pliber\u0161ek, T., Valen\u010dak, A.O., and Matos, T. (2023). Different BD BACTEC\u2122 blood culture bottle types for the detection of fungi in simulated sterile body fluid samples. Diagnostics, 13.","DOI":"10.3390\/diagnostics13101699"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/j.1348-0421.1999.tb02459.x","article-title":"Salt-sensitive growth of Staphylococcus aureus: Stimulation of salt-induced autolysis by multiple environmental factors","volume":"43","author":"Ochiai","year":"1999","journal-title":"Microbiol. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3757","DOI":"10.1099\/00221287-143-12-3757","article-title":"Influence of Na+ and anions on the dimorphic transition of Candida albicans","volume":"143","author":"Northrop","year":"1997","journal-title":"Microbiology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1080\/10715762.2018.1468564","article-title":"N-Acetylcycteine as an antioxidant and disulphide breaking agent: The reasons why","volume":"52","author":"Aldini","year":"2018","journal-title":"Free Radic. Res."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Phuengmaung, P., Somparn, P., Panpetch, W., Singkham-In, U., Wannigama, D.L., Chatsuwan, T., and Leelahavanichkul, A. (2020). Coexistence of Pseudomonas aeruginosa with Candida albicans enhances biofilm thickness through alginate-related extracellular matrix but is attenuated by N-acetyl-L-cycteine. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.594336"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1080\/00362177585190141","article-title":"A re-evaluation of the effect of cysteine or Candida albicans","volume":"13","author":"Wain","year":"1975","journal-title":"Sabouraoudia"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Nunes, T.S.B.S., Rosa, L.M., Vega-Chac\u00f3n, Y., and de Oliveira Mima, E.G. (2020). Fungistatic action of N-acetylcysteine on Candida albicans biofilms and its interaction with antifungal agents. Microorganisms, 8.","DOI":"10.3390\/microorganisms8070980"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Choe, K.W., Lim, Y.K., and Lee, M.K. (2023). Comparison of new and old BacT\/ALERT aerobic bottles for detection of Candida species. PLoS ONE, 18.","DOI":"10.1101\/2023.07.04.547669"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1136\/jcp.34.2.221","article-title":"Effect of adding cysteine to brain-heart infusion broth on the isolation of Bacteriodes fragilis from experimental blood cultures","volume":"34","author":"Shanson","year":"1981","journal-title":"J. Clin. Pathol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1128\/jb.80.4.472-476.1960","article-title":"Some growth requirements of Bacteroides fragilis","volume":"80","author":"Tamimi","year":"1960","journal-title":"J. Bacteriol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Leo, S., Cherkaoui, A., Renzi, G., and Schrenzel, J. (2020). Mini review: Clinical routine microbiology in the era of automation and digital health. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.582028"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3947\/ic.2016.48.2.91","article-title":"Anaerobic bacteremia: Impact of inappropriate therapy on mortality","volume":"48","author":"Jieun","year":"2016","journal-title":"Infect. Chemother."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/4\/468\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:34:34Z","timestamp":1760027674000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/4\/468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,14]]},"references-count":46,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["diagnostics15040468"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15040468","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,14]]}}}