Abstract
We aimed to compare the performance of BacT/ALERT and BACTEC blood culture systems in detecting bacteremia in simulated and clinical samples. Antibiotic neutralization tests using specific microorganism–antibiotic combinations were conducted to simulate bacteremia. Blood cultures from 228 hospitalized patients in the emergency and intensive care units were collected bilaterally and in duplicate. In the simulated scenarios, Candida albicans was detected at a 100% rate solely in the BacT/ALERT FA Plus aerobic bottles. For Bacteroides fragilis treated with meropenem, BacT/ALERT FN Plus anaerobic bottles achieved full detection, whereas BACTEC Lytic/10 anaerobic/F bottles failed. Among the 228 patients, the bacteremia positivity rate was 17.97% for BacT/ALERT bottles compared to 11.52% for BACTEC bottles. Moreover, the positive detection rates for the BacT/ALERT FN Plus anaerobic and BACTEC Lytic/10 anaerobic/F bottles were 15.20% and 5.99%, respectively. Notably, 100 clinical strains were identified, with BacT/ALERT identifying 15 types (65 strains) and BACTEC identifying 10 types (35 strains). Only BacT/ALERT FN Plus anaerobic bottles effectively adsorbed meropenem. BACTEC Lytic/10/F anaerobic bottles may miss bacteremia cases associated with carbapenem use. Compared to BACTEC, BacT/ALERT exhibited higher positivity rates and superior detection capabilities.
Data availability
The data supporting the findings of this study are available from the corresponding author upon reasonable request. Restrictions apply to the availability of some clinical data, which were used under the ethical approval of this study and are therefore not publicly available. Full details of the data access procedures can be obtained by contacting the Ethics Review Committee of the Department of Laboratory Medical Center, General Hospital of Northern Theater Command.
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Funding
This work was supported by the project of “Design and Utilization of Electrochemical Biosensors Based on Lactate Dehydrogenase Derived from Psychrophilic Microorganisms” (2024JH2/102600289), the Liaoning Provincial Applied Basic Research Program (2022JH2/101500025), and the Independent Scientific Research Project of General Hospital of Northern Theater Command (ZZKY2024032). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Xu Jiang and Dan Wang conceived the study, and Nan Wan contributed to the study design. Hu Bingtao obtained the clinical data, which were interpreted by Liu Jing and Lu Wang. Xu Jiang and Dan Wang drafted the manuscript. Nan Wan critically revised the manuscript. All the authors have read and approved the final manuscript.
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This study has been approved by the Ethics Committee (Y9/2025/062), based on the relevant regulations of the “Administrative Measures for Investigator - Initiated Clinical Research (2024)” issued by the National Health Commission, the “Measures for Ethical Review of Biomedical Research Involving Human Subjects (2016)” issued by the National Health and Family Planning Commission of the People’s Republic of China, the “Measures for Ethical Review of Life Science and Medical Research Involving Human Subjects (2023)” jointly issued by the National Health Commission, the Ministry of Education, the Ministry of Science and Technology, and the National Administration of Traditional Chinese Medicine, as well as the “Guidelines for the Construction of Ethical Review Committees for Clinical Research Involving Human Subjects (2023)” jointly formulated by the National Health Commission and the Chinese Hospital Association. The trial was registered at the Clinical Trial Registration Center on February 24, 2025 (NCT02694874).
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Wang, D.D., Jiang, X., Hu, B.T. et al. Comparative analysis of the detection capabilities of BacT/ALERT and BACTEC blood culture systems for simulated and clinical bacteremia specimens. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46118-4
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DOI: https://doi.org/10.1038/s41598-026-46118-4
