Implementation of Dual Incubation Strategies to Improve Anaerobic Culture Yield in the Clinical Laboratory

ABSTRACT Anaerobic bacteria are critical pathogens implicated in a variety of human infections, yet their recovery from clinical samples remains challenging because of their fastidious nature and sensitivity to oxygen. Establishing adequate and effective methods to recover clinically relevant obligate anaerobic organisms and reduce the recovery of facultative aerobic organisms from anaerobic cultures is critical for the clinical diagnostic value of anaerobic culture, laboratory workload, and workflow. This study describes a quality improvement (QI) project that focused on a simple, yet effective way to improve the recovery of anaerobes in clinical cultures through alteration of methods for initial incubation at specimen processing. This included the addition of single-use anaerobic bags for initial incubation prior to batched culture storage in large anaerobic jars to improve recovery of obligate anaerobes by minimizing exposure of the organisms to nonanaerobic conditions during initial processing. Our data showed that reducing the interval between specimen setup and the establishment of anaerobic conditions, by implementing the use of anaerobic bags, significantly improved recovery of obligate anaerobes by 22.22%. The findings from this QI project highlight that using a combination of methods for anaerobic culture can improve workflow and time to anaerobic conditions resulting in better recovery of anaerobic organisms.