14 August 2026 Articles

New evidence for more accessible blood culture diagnostics

ITM researchers find that blood culture bottles and automated systems from different manufacturers can, in most cases, be used interchangeably

In a recently published study in The Lancet Microbe, ITM researchers from the Department of Clinical Sciences address a simple but important question: can blood culture bottles from one manufacturer be used with automated blood culture systems from another? The findings could lead to improved access to bloodstream infection diagnostics in resource-constrained settings, where the stakes of complicated single-supply chains are highest.

Blood cultures are instrumental for detecting microorganisms in the bloodstream and guiding the treatment of serious, potentially life-threatening infections such as sepsis. Automated blood culture systems, which are machines that detect growth in the blood culture bottles, all have their own brand-specific blood culture bottles. This closed design locks laboratories into a single supplier. In high-income countries, that's an inconvenience. For laboratories in resource-constrained settings, the stakes are higher.

Not many laboratories in sub-Saharan Africa have the capacity to diagnose bloodstream infections, and the few that do are still hindered by the consequences of single-supply chains: higher costs, supply shortages, and, when bottles run out, no reliable way at all to diagnose infections.

Breine, A., Vermoesen, T., Corsmit, E., Genbrugge, E., & Hardy, L. (2026). Interchangeability of blood culture bottles and automats for blood culture systems: An in-vitro performance evaluation. The Lancet Microbe. Advance online publication. https://doi.org/10.1016/j.lanmic.2026.101438

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Blood culture bottles at ITM

But do the blood culture bottles and systems actually need to come from the same manufacturer? Or is that simply a consequence of how the market is currently structured? This is the question that the ITM team wanted to answer.

“We noticed that the blood culture bottles from different manufacturers looked all very much alike, so one day in the lab we decided to quickly evaluate whether we could interchange them. This small pilot study was successful and led to this quite elaborate project,” says Anke Breine, postdoctoral researcher at ITM and first author of the study.

Different colour indicators of the different blood culture bottles

About the study

The researchers tested blood culture bottles and automated blood culture systems from four different manufacturers. By combining bottles and systems, they were able to compare 11 different bottle-system combinations.

To make the comparison as robust as possible, they selected 20 bacterial and fungal species that commonly cause bloodstream infections. For each species, they tested several different strains, including strains isolated from patients. Small, clinically realistic amounts of these microorganisms were added to blood samples, which were then tested with each bottle-system combination. Every experiment was repeated three times to ensure reliable results. The researchers also tested blood samples without any microorganisms, to check that the systems would not produce false-positive results.

Altogether, the study included 4,620 inoculated blood cultures (containing microorganisms) and 301 negative-control cultures (without microorganisms), making it one of the largest and most systematic comparisons of its kind.

Promising results

The results show that blood culture bottles and automated systems from different manufacturers can, in most cases, be used interchangeably without compromising accuracy or speed of detection.

That matters most for laboratories in low- and middle-income countries. If bottles and machines don't have to come from the same manufacturer, laboratories could choose bottles based on what is actually available, at what quality and at what cost, rather than being locked into a single supplier by their equipment.

Liselotte Hardy laadt bloedkweekflessen in bloedkweekmachine_ITG_web

Liselotte Hardy puts a blood culture bottle into the blood culture system

What's next?

These results come from a controlled laboratory setting. The next step is to confirm the findings using clinical samples in a randomised controlled trial, to make sure interchangeability holds up when taking real-world variables into account. These findings could help make blood culture diagnostics more resilient, affordable and accessible worldwide.

“This study is somewhat controversial, but a typical example of applied and out-of-the-box research that is needed to improve access to diagnostics in resource limited settings,” says Professor Liselotte Hardy, Head of ITM’s Unit of Tropical Bacteriology and last author of the study.

The study was made possible with support from the Department of Economy, Science and Innovation of the Flemish Government, through ITM’s Health Innovations for All programme.

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