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Nor
BRISTOL-MYERS SQUIBB-LAWRENCEVILLE
TITLE: Bactec 9050Automated BloodCulture
LABORATORY PROCEDURE
DATED: 3/13/98
AUTHOR: Trisha Cohen
REVIEW DATE:
OVERVIEW:
The detection of microorganisms in a patient's blood has diagnostic andprognostic
importance. Bacteria enter the blood from extravascular sites such as the genitourinarytract,
respiratory tract, abscesses, surgical wound infections and other miscellaneous sites eitherdirectlyor via the lymphatic vessels. When bacteria enter and/or multiply in the bloodstream ata rate that exceeds the capacity of the reticuloendothelial system to remove them,bacteremiaresults.
Blood cultures are essential in the diagnosis and treatment of the etiologic agents ofsepsis.Bacterial sepsis constitutes one of the most serious infectious diseases and therefore theexpeditious detection and identification of blood borne bacterial pathogens is animportantfunction of theclinical diagnosticlaboratory..
The Bactec 9050 instrument is designed for the rapid detection of microorganisms inclinicalcultures of blood. The sample to be tested is inoculated into thevial which is entered into theBactec 9050 for incubation and periodic reading. Eachvial contains a sensor whichdetectsincreases in CO, produced by the growth of microorganisms. The sensor is monitored by theinstrument every ten minutes for an increase in its fluorescence,whichis proportional to theamount of CO, present. A positive reading indicates the presumptive presenceofviablemicroorganisms in thevial.
a.40mL Enriched Soybean-Casein digestbroth.b. 0.02%SPSc.Resinsd. CO,e. 0,f. Sensor for CO,detection
2. Bactec Plus Anaerobic/F Culture VialOptimum blood volume for each vial 8-l0mL; 3-10mL isacceptable
Each vialcontains:a. 25 mL pre-reduced enriched Soybean-Casein digestbrothb. 0.05%SPSc.Resinsd. CO, andN,(which support thegrowth of anaerobicmicroorganisms)
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PROCEDURE
Now
vow
Specimen labeling:Eachvial should be labeled with the appropriate patientinformation:
• PatientIdentification
• LaboratoryLogNumber
• PatientLocation
• Date and Time ofCollection
• Collector's Initials
• Site ofVenipuncture
Fntering newvials:
• Press the 'VialEntry'key.
• Scan vial barcode by placing thevialin the alignment block in front of the scanner with thebarcodefacing the scanner. Rotate thevialslightly in front of the scanner. Thesystembeeps once to indicate a successfulscan.
NOTE: If thevial barcode cannot be read, press the 'No Barcode'key. Selectthevialmedia by using the Up/Down arrow keys. Press the 'Ok'key toconfirm mediatype.
• Insert the vial into position indicated on theLCDdisplay.
• If default protocol is acceptable, press`Ok'key.
NOTE: To modify the protocol length for a particularvial, select the 'ChangeProtocol'key.Select the desired protocol length using the Up/Down arrow keys. Press 'Ok' toconfirm protocollength.
• Verify thatallinformation is correct and thatvial has been inserted into the indicatedstation.Press 'Ok' keytoconfirm.
• Repeat the above steps for each newvial. Then Press the 'Exit'key.
Positive Vials:A. Notification of the presence of presumptive positivevials
• An audible alarm sounds if configured to a volume> O.
• The New Positive Indicator on the front of the instrument flashesred.
• The 'Remove Positives'key appears in the LCD display when the dooris open.
• On the main status display. that station with the positive vial is displayed as a filled circle
with a plussign in it, and the positive total in the summary regionreflects the number ofpositives in theinstrument.
B. Removal of positivevials
• Press the'SilenceAlarm' key to acknowledge thealarm.
• Open instrument door and press the `Remove Positives'key.
• LCDdisplay identifies the positivevialby position and the barcode numberis alsodisplayed.
• Removevialfrom the station and scan the vial barcode. Repeat the above steps until allpositives are removed (three beeps indicates all positives have beenremoved).
• Press the 'Exit"key.
NOTE: A subculture and a Gram stain should be performedfrom eachpresumptivepositivevial.
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\me
NegativeVials.
A.Removal
• Open instrument door
• Press the 'Remove Negatives'key.
• LCD display identifies negativevials by position and thevial barcode numberis alsodisplayed.
• Remove thevial from the station and scan the vialbarcode.
• Repeat the above steps until all negatives are removed (three beeps indicate the process iscomplete).
• Press the 'Exit' key and close door.
J IMITATIONS OF THE PROCEDURE:
Contamination
Care must be taken to prevent contamination of the sample during collection andinoculationinto the Bactec vials. A contaminated sample will give you a positive reading, but this does notindicate a clinicallysignificantresult.
Recovery of SPS Sensitive and Fastidious Organisms fromBloodSamples
Because blood can neutralize the toxicity of SPS toward organisms sensitive to SPS (such as
some Neisseria species), the presence of optimum volumes of blood, based on mediatype,benefits the recovery of theseorganisms.
Some fastidious organisms, such as Haemophilus species, require growth factors, such as
NAD, or factor V, which are provided by the blood specimen. If the blood specimen volume is
3.0mL or less Bactec Peds Plus, an appropriate supplement may be required for recovery ofthese organisms. Bactec Brand FOS (catalog #4402153) or Horse serum andDefibrillatedsheepblood may be used asnutritionalsupplements.
fleneral Considerations
Optimumrecovery of isolates will be achieved by adding the appropriate volume of blood for
the type ofvial inoculated. Use of lower or higher volumesmay adverselyaffectrecovery
and/or detection time. Blood may contain antimicrobials or otherinhibitors which maysloworprevent thegrowth of microorganisms.False negative readings mayresult whencertainorganisms do not produce enough CO, to be detected by the system or if significant growth hasoccurred beforeplacing thevial into the system. Falsepositivity may occur when the whiteblood cell countis high.
DUALITY CONTROL:
Each case of media has a certificate indicating that the media lot has been tested. However,the laboratory should also test each shipment of media through use of a positive andnegativevial test. Thepositivevial should be inoculated with 1.0ml of a 0.5 MacFarland standard of
either Escherichiacoli or Staphylococcus aureus. Thisvial and an uninoculatedvial should be
placed into the machine and tested. The inoculatedvial should he detected as positive within 72hours. The negative controlvials should remain negative throughout the entire testingprotocol.
The BACTEC® 9050 instrument is designed fortherapid detection ofbacteria
andfungiinclinicalcultures of blood. Samples aredrawn frompatients and in-
jected directlyintoBACTEC culture vials.Vials arethenentered into the instru-
ment assoon as possible to insureperformanceefficacy.
When microorganisms are present, they metabolizenutrients inthe culture me-dium, releasingcarbondioxideinto the medium.Adyeinthesensor reacts withCO2.This modulatestheamount of light that is absorbed by afluorescent mate-rial in the sensor.The instrument's photo detectors measure the level of fluores-cence,whichcorresponds to the amount of CO2 released by organisms. Thenthe measurement is interpreted by thesystem according to preprogrammedpositivity parameters. (See Figure I.)
Atsystem start-up, the BACTEC® 9050 instrument performs self-diagnosticsand loadsits operating instructions.Then the instrument begins automated test-ing.A row of LightEmittingDiodes (LEDs) behind the vials illuminate,activatingthe vials' fluorescentsensors.Theinstrument's photo detectors thentake thereadings.A test cycle is completed every ten minutes. Positive cultures are imme-diately flaggedby an indicator light on the front of the instrument, an optionalaudible alarm, andare displayed on the LCDscreen.
Whenpositive vialsareidentified, the lab technologist pulls them from the in-strument for confirmation of results, and for isolation and identification of theorganism.
An instrument is capable ofmonitoring a total of 50 BACTEC®culturevials.Thepractical capacity is 5 culture sets per day with a 5-daytestprotocol.The vialsarearranged in 3 concentricrings designatedA, B, and C.The vials arecontinuously
incubated at 35° C, andare agitated formaximum recovery oforganisms.
Major features of the BACTEC® 9050 instrumentinclude:
♦ Automated, continuous, unattended testing ofcultures through non-
invasive fluorescenttechnology
♦ Minimumuser interaction and handling
♦ Immediate notification of positivesthrough an indicator lamp, indica-
tion on the LCD display, and an audiblealarm
♦ Simple userinterface,with pictureicons to guideyou through setup
and routineoperations
♦ Incubation and agitation for all cultures
♦ Proven BACTEC® culturemedia
1.2 InstrumentOverview
The BACTEC® 9050 instrument(hardware) components are described in the
*Ik
following paragraphs and are shown in Figure 2.Controls andindicators for thesemodulesare discussed in Section 3 - Controls andIndicators.
Themajor subsystems of the instrument include the following:
Rotor
The rotor contains 50 wells called "vial stations," into which vialsare placed forincubation and testing.The rotor contains three rings of vialstations designatedA, B, and C. Eachstationis numbered uniquely (I - 50), but the systemprovidesthering letter designation(A, B, or C) to help you quicklyidentify where toplaceor remove vials. One row of stations(onestationin eachring) containsthetestLEDs that activate vial sensors and the photo detectorswhich taketheactualreadings.
The rotor is mounted at a 20° angle androtates to provide agitation to culturevials.Agitation ofcultures canimprove both time to detection and recovery oforganisms. The rotor's drive motorstops agitation when the cabinet door isopened.
The temperatureinside the instrument is preset tomaintain the internal tem-perature at 35° C ± 1.5° C.Over- andunder-temperature alarmsetpoints arepreset at 35.5° C and34.5°C,respectively.
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5ACTECD 9050 System User'sManual
Temperature L.)tandards
Vial Stations Rotor
Figure 2 - 13ACTEC'"9050Instrument
Keypad and LCD Display
The LCD Display is a 240 X 64 pixel LiquidCrystal Display that presents informa-tion about system status andfunction key definitions that enable you to performsystem operations. Key definitions and status information are identified bypictureiconsthatrepresent thetypeof information oroperationthat canbeperformed.A comprehensivelist of system icons is presented in Section 5 —Reference.
The keypad enablesyou to performoperations such as entering and removing
vials,adjusting setup parameters,etc. Four of the keys, marked with printedicons,
perform fixedfunctions regardless of the current display oroperation. Six otherkeys, teal in color,aresoftware(soft) keys whosefunctions vary depending on
the current active display. Each display shows iconsrepresenting the currentSoft
key assignments at the bottom of thescreen. To perform the function repre-sentedby the icon, you press the correspondingSoft key below theicon.
Barcode Scanner
A barcodescanner is located on the front of the instrument to provide theability to scanvial labels for specimen identification.The scanner turns on auto-
matically whenever a barcode needs tobescanned.
Computer
Thesystem computer stores all thesystem software,including the softwarewhich controls instrument operations andtheuser interface, which enablesyouto perform instrumentoperations, view vial statuses,print reports,etc.
4 MA-0103-D
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Afloppy disk drive is located on the front of the instrument to enable the instal-lation of software updates and tocopy important data files tofloppy disk.
External Ports
Ports on the rear of the instrument allow theuser to connect an optional Re-moteAlarm unit and an optional printer.Two other portsare for FieldServicediagnosticuse.
Instrument Calibration
Components of the BACTEC® 9050 instrumentare selected and designed tomaintainelectrical andoptical integrity throughout the product's life.All instru-ments arecalibrated at the factory prior to shipment, and should not requirerecalibrationduringthe usable life of theinstrument, unlesscertaincomponentsare replaced.Calibration helps to insure that anyfluorescent seriesmedium vialin any station will have initial and finalfluorescent values within a specifiedrange.
1.3 SoftwareOverview
Thesystem software presents a simplified userinterface on the LCDDisplay,with pictureicons torepresentall the functions,operations, setupparameters,andstatus conditions (see Section 5 - Reference forcharts of all icons). Routinesystem operationsareperformedby pressing the teal soft key thatcorrespondsto the definitionshownon thescreen.
There arethree basictypes ofdisplays:
Main Status Screen - When the instrument door isclosed,this screen
appears. It showsthenumber of vialsthatare positive, negative, ongo-ing, available, and stations that are in error or anonymous. Alsoshownare the current date and time and the instrument temperature. Soft-ware keys allow you to configure the setup parameters, reviewsystemerrors, or print the System StatusReport. See Figure 3.
ConfigurationScreens -Accessible from the Main Status Screen,the Con-
figuration Screens allowyou tosetthe protocol length, the time andtime format, the date and date format,theaudiblealarm volume, theinstrumentidentification number, the DVE (Delayed VialEntry) thresh-old (feature not available foruse in the USA), to select thedesiredlanguage for reports, to write data to a floppy disk, and to update sys-tem software.
Activity Screens -When the instrument door is opened, software key defi-
nitions appear that enable you to enter new vials, remove positivevials,remove negative vials, identify anonymous vials, andresolve station er-
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BACTEC") 9050 System User'sManual
Figure 3 — Main StatusScreen
1.3.1 Built-in-Test (PatentPending)
The system software is designed tocontinuously monitortheelectrical and op-ticalperformanceof allstations simultaneously.Thisfunctionality, calledBIT (forBuilt-in-Test), automatically monitorseachstation every ten minutes forbasicoperational characteristics.Thesetests continually verify that signal output foreachstation is within design limits; this includesbothempty stations andstationswithongoingvials.
Two different signal levelsare used to verifyoperation of the station over theestablished signal range.Testsareperformed on dark readings (the outputfromthestationwhenits excitationLEDs areoff) andon fluorescence unitreadings(the outputfrom thestation when a vialis present and the excitation LEDsareon).
Dark readingsare evaluated to be belowamaximum established range.Whenthey exceed that range, the software declares the station in error. High darkreadings may indicate a light leakinthecabinetor anelectricalfailurewithintheinstrument.
Fluorescence unit readingsare evaluated to be within a specifiedmaximum andminimum range which has been established for the instrumentduringcalibrationat thefactory. Should an out of range reading occur,thesoftware declares thatstation in error.This mayoccur due to anelectrical oroptical componentfailure.
Additionally, the fluorescence readingsare evaluated for consistencywhilevialsare in stations. If consecutive fluorescence unit readings vary by more than apredetermined amount, thestation is declared in error.This featuredeterminesthestability and the acceptability of astation for useduring protocol.
These protection featuresverify that calibration has been maintained for all sta-tions withinthe system, andinsurethat theuser isalerted ofelectronic or opti-cal changes or failureswhich may be significant enough toaffectresults.
Thefunction ofBIT can be demonstrated by entering a vial intotheinstrument,andthenremovingthat vial from thestation without scanning it out.The result-ing error is the response of the BITfunction.The user may resolve the error byusingtheresolve errors softkey.
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MA-0 IX5-3
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SectionI —Introduction— provides anoverview of the BACTEC® 9050
instrument and its uses in the microbiology laboratory, its major hard-ware and softwarecomponents.An overview of this manual's struc-tureand conventions is alsoincluded.
TheIndexprovides a listing ofmajor topics and associated pagenumbers.
1 -Introduction
1.5 Use of thisManual
This user's manual is designed as a reference tool for technologists,supervisors,and other personnel whooperate and maintain the BACTEC° 9050 instrumenton a regular basis. Everyattempt has been made to include all informationwhichwould be required duringnormaluse and maintenance of the system. Should aquestion arise which is not answered in this manual, please contact the following
parties(USA):
For assistance with mechanical, electrical, orsoftwareperformanceproblems:
presents instructions on how to perform routine operations on theBACTEC® 9050instrument,in a step-by-step,interactivetutorial format.
BACTEC® Blood Collection Instructions,MA-0108 - This documentpresents
information oncollection of specimens for use with the BACTEC® fluores-cent instrumentseries.
BACTECMediaPackage Inserts -Thesedocuments contain important infor-
mation on the use, storage, inoculation, performance,andlimitations ofeachtypeof BACTEC medium.They are included with eachcarton of media, andare available upon requestfrom the Technical Services Department.
1.6 Conventions
1.6.1 General
Keys
The four keys that have fixedfunctions are the UP ARROW (Increase) Key, the
DOWN ARROW (Decrease)Key,the HOMEROTORKey, and theSILENCEALARM Key.These keysaremarked with symbols representing theirfunctions,and operateidentically regardless of theactive display or operation. Six other
keys, the Software (Soft) Keys are teal in color, andhavefunctions that varydepending on the active display. Each display showsicons representing the cur-
rentSoft key assignments at the bottom of the screen.To perform the function
The four fixedfunction keysare always identified in your BACTEC® 9050 docu-
mentation byCAPITAL LETTERS (e.g., SILENCEALARM key).Thesoftwarekeysare always identified by lowercase lettersinquotes, and the words soft key(e.g.,"vial entry" softkey).
End of Section
The end of each section of this manual is marked with an octagonal symbol. •
1.6.2 Symbols Used on the Equipment
The following symbols appear on the BACTEC® 9050 instrument:
8 MA-0'03-5
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Top figure: Symbols for Sena! Port, Remote Alarm Port. Printer Port,Keyboard
Port, Power On and Off Center figure. Symbol for electrical groundconnection:
Bottomfigures: Left — Symbolforelectricalhazard, Right- Symbol far "refer to
accompanying documentation" for instructions (specifically, theMaintenance
sectionofthe user'smanual)
-1`
1.6.3 Notes, Cautions, andWarnings
Throughout this manual, importantinformationis presented in boxesoffsetfromthe regular text, and is labeled as either a NOTE, CAUTION, or WARNING.These messages are formatted asshown below and bear the following signifi-cance:
NOTE
Important information about system use worthy ofspecial
attention is presented asaNOTE.
MA - 0103
CAUTION
Information on an activity which potentially could
cause damage to the instrument or system is presented
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BACTEC®9050System User'sManual
1.7 SummaryofWarnings andCautions
Special messages presented in this manual whichrelate to operator and instru-ment safety,and which appear as CAUTION and WARNING boxes inthemanual,are summarized below. Please readthis section completelybeforeyou begin tooperate your BACTEC® 9050instrument.
For all instruments withserialnumbers from 1000 — 1695,parts replacementsshould be performed byservicepersonnel only. Instrument power should be
turned off, and the power cordshould bedisconnected,before beginning any
modulereplacementprocedure.
The intakefilters onthe sides of the instrumentmust remainunobstructedatall
times.Restrictedair flow may cause excessivetemperatures in the instrument,
which canaffect organismrecovery and possibly causehardwaremalfunctions.
Because of its size and weight, two personsshould lift the BACTEC® 9050 in-strument.
It ismandatory that all system users becomethoroughly familiar with allcontrols
andindicators before attempting to operate the instrument.
The doorsensor helps protect you from possible injury fromthemovement of
the rotor. Do nottamper with the doorsensor in any way, or attempt to defeat
itsfunction.
Never attempt to insert or remove vials when the rotor is in motion.
"UniversalPrecautions"'shouldbe followed in handling allitems contaminated
with blood or otherbody fluids.
' Recommendations for Prevention of HIV Transmission in HealthCare Set-tings.MMWR 1987; 36 (Supplement #2S): (Inclusive PageNumbers).
Vials should be handled withextremecare at alltimes, and should not beforced
into or out of stations.Vial necksare susceptible to breakage if they are struck
against anotherobject.
When the systemnotifies you ofalerts and errors, you shouldimmediately re-
spond to thecondition.
All maintenance and repair otherthantheprocedures describedinSection6 —
Maintenance,must be performed by qualifiedservicepersonnel.For all instru-
ments withserial numbers from 1000 —1695,parts replacements should be
performedby service personnel only.
All portions of the body thatcould possiblycomein contact with theaffected
instrument surfaces must be completely covered before beginning the decon-
taminationprocess.
After the rotoris removed, DO NOT lay it down on either the front orback
sides. (On therear,thetabs can snapoff.) Stand the rotor upright and wedge
both sidesso it does notroll.
If any error sub-codes other thanthose listedhere appear,contact FieldServiceforassistance.
If the recommended corrective actions do not solve theproblem,contact Bec-
•
tonDickinson atthenumbers providedinAppendix D.
10
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WARNINGS/CAUTIONS relating to the use of BACTEC MYCO/F
LYTIC culture vials with the BACTEC 9050 instrument:
Biosafety Level 2 practice, containment equipment, and facilities are recom-mended forpreparing acid-fast stains and for culturing clinicalspecimens.For activities involving the propagation and manipulation ofMycobacteriumtuberculosisorMycobacteriumspecies grown in culture, BiosafetyLevel 3practice, containment equipment,and facilitiesare required asrecommendedby CDC.
Because an inoculatedleaking or brokenvialmay produce an aerosol ofmycobacteria, includingM.tuberculosisor otherbacteria, appropriate han-dling shouldbeobserved.
If aninoculated vialis found to be leaking or is accidentallybroken duringcollection or transport, use the established procedure in yourfacility fordealing withmycobacterial spills. As a minimum,"UniversalPrecautions"should be employed.Vialshouldbe discarded in an appropriate manner. Inthe rareinstance whereavial is found tohave leaked contents into theinstrumentproper, or if a vial is accidentlybroken, turn off the instrumentimmediately.Vacate the affected area.Contact your facility's Safety or Infec-
tion Control Officer(s).Determinethe necessity of turning off ormodifyingthe settings of the air handling units serving the affected area. Do not returnto the area until any potential aerosols havesettled or have beenremovedbyappropriateventilation. BectonDickinson Microbiology Systemsshouldbe notified by calling1-800-544-7434in the U.S.A. or theappropriateBectonDickinson representative in your area. Guidelines for proper handling ofaccidental mycobacterialcontamination due to breakageofculture tubes orbroth suspensions have been issuedby the CDC.'
Ifrecovery of mycobacteria is intended, CDC-NIH guidelinesstrongly rec-ommend that the test instrument be placedinthemycobacteriology labo-ratorywherethe additional safety issues thattherecovery ofmycobacteriapresent canbeaddressed.
•
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The BACTEC® 9050 instrument should be installed in an area that is free fromundue vibration, direct sunlight, highhumidity,dust,temperatureextremes,andcorrosive or explosivevapors or gases.The system will operate within specifica-tions in room temperatures between 18.3° — 32.0° C (65° — 89.6° F).Relativehumidity shouldbebetween 10% and 90% (non-condensing). Clearances on allsides should be at least 12 inches. Environmentswhichexceedtheselimits couldadverselyeffecttheperformance of the systemcomponents.
The incubator should maintainits temperature to within plus or minus 1.5° C ofthe temperaturesetting(35° C).This accuracy can be assured only if the roomtemperature meets therequirements givenabove.
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15
BACTEC9050System User'sManual
2.3 Installation
Complete instructions on unpacking andinstallation of the BACTEC® 9050 instru-ment are provided in theseparate document titledBACTEC9050 Installation andSetup,MA-0102.
CAUTION
The intake filters on the sides of the instrument must
remain unobstructed at all times. Restricted airflow
may cause excessive temperatures in the instrument,
which can affect organism recovery and possibly cause
hardware malfunctions.
2.4 InstrumentSetup
2.4.1 General
The BACTEC® 9050 instrument ships withallsetupparameters preset to fac-tory default values.Before using the instrument for blood culturetesting,youshould review the instrumentsetup parameters toseeif theyaresuitable foryour laboratory.These parameters are described in Section 2.4.2— Setup Param-eters, andinclude:
♦ TestProtocol Duration
♦ Time Format andTime
♦ DateFormat and Date
♦ AudibleAlarmVolume
♦ Instrument Number
♦ DVE (Delayed Vial Entry)Media Thresholds(feature not available for
useintheUSA)
♦ Language (for System Status Report)
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After reviewing and adjustingthesetup parameters, youshould carefullyreviewthematerial in the BACTEC®90505-MinuteOperatorTraining Guide,MA-0104.This one-page guide will familiarizeyou with routine use of the BACTEC® 9050instrument.
Whenyou arefamiliar with systemoperation, you mayproceed withautomatedBACTEC®culturetesting.
2.4.2 Setup Parameters
To review and/oradjustthe instrumentsetupparameters,firstmakesure the
instrument door is closed.When the door is closed, a display liketheoneshownbelow appears (note that printer and system alert icons may notbeshown):
Figure 5 —Main Status Screen
Any changes to configuration parameters are ineffectfrom thetimeof thechange
forward. Changes do notaffect vials thatare currentlybeingtested (Ongoing
vials).Alsonote that any changesyou makecannotbe"cancelled" per se —youmust manually change the new value back toits previous value.
Toenter configuration mode, pressthesoft key corresponding to the iconshownbelow(the "configuration" soft key).(For acomplete listing of systemicons,seeSection 5 —Reference.)
When you enterconfiguration mode, the first of nine setup displays(Test Proto-col Duration)appears.
TestProtocol Duration (1/9)
6 There arethreetest protocolduration settings: General media, Myco-
sis/IC—F* medium, and Myco/FLytic medium.When this display is firstaccessed, the test protocol for generalmedia(allmediatypes other
than Mycosis/IC—F* and Myco/F Lytic) is highlighted.The defaultsettingis 5 days.To increase or decrease the number of days for general media, use the UPARROW or DOWN ARROW key. You can choose from 4 to 7 days.
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BACTEC'9050System User'sManual
To adjustthetest protocol duration for Mycosis/IC—F medium (not available foruseintheUSA) pressthe"move to other field" soft key to highlight that field.Use the UP ARROW or DOWN ARROWkey to increase or decrease the dis-played value.You canchoose from 5to42 days.The default value is 14days.
To adjust the test protocol duration forMyco/FLytic medium, press the"moveto other field" soft key to highlight that field. Use the UP ARROW or DOWNARROW key to increase or decrease the displayed value.You can choosefrom 5to 42 days.The initial default valueis 42 days.The recommended testingprotocolfor the following organisms are: 7 days for yeast, 30 days for fungi, and 42 days formycobacteria.
Press the "configuration" soft key to advance to thenextsetup display, orpressthe "exit"softkey to exitconfigurationmode.
Time andTime Format (2/9)
23-01-94
12:2 4
01/23/99
12,24
When this display is first accessed, theminutes value ishighlighted.Toadjustthe minutes, usetheUPARROW orDOWNARROW key to increase or decreasethedisplayedvalue.
To adjust thehours value, press the"move to otherfield" soft key to highlight the
hours field. Use the UP ARROW or DOWN ARROWkey to increase or de-
crease the displayedvalue.
To adjustthetimeformat, press the "format'soft key (shown above).The default
time format(colon separated) is shown. Continue to press the "format"softkey
to rotate amongtheformat choices until the desired selection is shown.Youcanchoose amongperiod( .) or comma( , ) or colon( ;) separators.
Press the "configuration" soft key to advance to the nextsetup display,or press
the "exit"softkey to exitconfigurationmode.
Date andDate Format (3/9)
23-.01-94
II
12:2 4
.:::1123/94 fault, the right field) is highlighted.To adjust the year,use
When this displayis first accessed, the year value(atde-
12,24 the UP ARROW or DOWNARROW key to increase or
decrease the displayedvalue.
Toadjust the day value (at default,themiddle field), press the"move to otherfield" soft key to highlight the day field.Use the UP ARROW or DOWN AR-ROWkey to increase or decrease the displayedvalue.
Toadjust the monthvalue (at default, the left field), press the "move to otherfield" softkey to highlight the month field.Use the UP ARROW or DOWNARROW key to increase or decrease the displayedvalue.
To adjust the dateformat, press the "format"soft key(shown above).The default
date format (MM/DD/YY) is shown. Continue to press the "format" soft key to
rotate among the format choices until the desiredselectionis shown.Youcan
choose from the following:
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Pressthe "configuration" soft keyto advancetothe next setup display, or pressthe "exit" soft keytoexit configuration mode.
Audible Alarm Volume (4/9)
can choose from 0 (audible alarm off)to10(loudest).
Pressthe "configuration" soft keyto advance to the next setup display, or pressthe "exit" soft key to exit configuration mode.
Instrument Number (5/9)
1 2 3
MM/DD/YY orMM/DD/YYYY
MM-DD-YY orMM-DD-YYYY
MM.DD.YY orMM.DD.YYYY
Select the volume of the instrument's audible alarm.The default set-ting is 5, which is at the center of the volume range.To increase ordecreasethe volume, use the UP ARROW or DOWN ARROWkey(a sample volume tone sounds each time you adjust thesetting).You
Select the instrument identification number.The default setting is I.To increase or decreasethe instrument number, use the UP AR-ROW or DOWN ARROW key.You can choose a number from Ito99. If there is only one instrument at your location, you shouldleave this value set at I .
DD/MM/YY orDD/MM/YYYY
DD-MM-YY orDD-MM-YYYY
DD.MM.YY orDD.MM.YYYY
YY/MM/DD orYYYY/MM/DD
YY-MM-DD orYYYY-MM-DD
YY.MM.DD orYYYY.MM.DD
Pressthe "configuration" soft keyto advancetothe next setup display, or pressthe "exit" soft keyto exit configuration mode.
DVE Media Thresholds (6/9)
This feature is not availablefor use in theUSA. For information on
On
DVE
Language (7/9)
MA-0103--D
use internationally, refertothe BACTECe 9050 Delayed Vial Entry In-
structions,MA-0113.
Selectthe language in which you want the System Status Reportto
print.The default setting is English.To scroll throughtheavailableselections, use the UPARROW or DOWN ARROW key.You canchoose fromthe following languageselections:
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BACTEC®9050System User'sManual
English
Spanish
French
German
Italian
Chinese
Japanese
Polish
Pressthe"configuration" soft key to return to the first setup display, or press the"exit" soft key to exitconfigurationmode.
Save Datato Disk (8/9)
1 pi111NitUnder certain circumstances, Becton Dickinson will adviseyou to
sert a blank,formatted,write-enabled floppy disk in the disk drive.Then press the"perform action"softkey.
Update Software (919)
Manual Updatedprogram software is furnished on 3-112inchfloppy disk(s), la-
beled "BACTEC® 9050 System Software,Version y.yyz"(where"y.yy" is the soft-wareversionnumber, and "z"is the revision).The associated catalognumber isalso printed on the label.
To installasoftwareupdate, insert thefloppy disk containing the newsoftwareinto thedisk drive,then press the "perform action" soft key to initiate the up-date. Thesystem reboots and thenimmediately begins to update thesystemsoftware(provided thedisk is formatted, is not write-protected*, andcontainseither the same or a later version of systemsoftware). The names of any filesbeing updated appear on the LCD Display, as well as a progressindication.Whenthe update is complete, the user interface loads andyou mayproceed with nor-mal system operation.
save system data to a floppy disk.These circumstances includesomeerrorconditions and system malfunctions. Tousethe function, in-
111 From time to time, updated versions of the system softwaremay
be provided to you. New software should be installed assoon as itisreceived, and logged on the form in Appendix C ofthis User's
* Note that write-protection does not have to be disabled withversion
1.1 or later of system software
2.5 System Start-up
Wheneverpower is applied totheinstrument, the system is initialized,performs
self-diagnostics, and reports any problems to the error file. If any files aremissingor corruptedwhichwouldprevent properoperation of the system,thestart-upprocess is aborted, If not, the computer loads the operating instructions andbeginsculturetesting.
•
20 MA-010:3-1)
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The system power (On/Off) rocker switch is on the rear of the instrument at thebottom right (see Figure 7).When in the "0" (Off) position,power is removedfrom the instrument. When in the"1" (On) position, poweris applied to theinstrument. Power must be turned on for theincubator,agitator,and culturetesting modules to work.For normal operation,thepower should remain On atalltimes (exceptduring some maintenanceprocedures).
Figure7 - On/Off Switch
3.3 Keypad and LCD Display
The keypad and LCD display arelocated on the front of the BACTEC® 9050instrument,atthe bottom center.The keypadis used to enter information andissue commands to the instrument.The LCD display presentssetupandstatusinformation. See Figure 8.
The controls and indicators of the keypad and LCDdisplay arepresented inclockwise order from the top right of themodule.
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BACTEC® 9050 System User'sManual
Figure 8 — Keypad and LCD Display
3.3.1 SILENCE ALARM Key
The SILENCE ALARM key is located at the top right of the Keypad/LCD Displaymodule. When pressed, it turns offthe audible alarm for thecurrent "alert"alarm. It does not silence "door open"type audible alarms. (See Section 3.7—Audible Tones and Alerts, for an explanation of alarm types andtones.)
3.3.2 HOME ROTOR Key
TheHOME ROTOR key is located onthe right side of the Keypad/LCD Displaymodule, belowthe SILENCE ALARM key. When pressed, it causestherotorinthe instrumentto returnto the"home" position, with the temperaturestandardbottlesinthe12:00 position. The HOME ROTOR key is active only whentheinstrument door is closed andtherotor is inmotion.
It is not necessaryto home the rotorpriorto opening the door. However, youmay find it easier tolocate vial stationswhenthe rotor is homed, sincetherotor's position then correspondsto the representation inthedisplay.
Note that if vial testing is in progress when the HOME ROTOR key is pressed,those test results are discarded.
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3 - Controls andIndicators
3.3.3 Alarm Indicator
TheAlarm indicator is located on the right side of the Keypad/LCD Display, at
the bottom. This light flashesyellowwhenever the system encounters an errorcondition that requires operator attention.The indicator continues to flash untilthe condition is corrected.
When an alarmoccurs, an icon(resemblingthe one above the Alarm Indicator)appearsinthesoft key assignments area of the Main Status Screen. Pressthesoftkeycorrespondingto the System Alert icon.The first error code is shown on thedisplay. Correct any errorconditions assoon as possible by following the direc-tions onthe door placard and inSection7 -Troubleshooting.
Ifthere is an audible alarm sounding, you can silence it by pressingtheSILENCE
ALARM Key.
3.3.4 Brightness Dial
The Brightness Dial is located below the Keypad/LCD Display, at the center. It isaknurled rotary dial. Rotate the dialclockwise to increase theoverallbrightnessof the LCD Display screen. Rotatecounterclockwise toreducethe brightness. Itis not uncommon to have to change the brightness setting ifyou change yourviewing angle.
3.3.5 SoftKeys
The six software (soft)keys arelocated near the bottom of the Keypad/LCD
Display,atthecenter. These keysareteal colored. None of the keys hasafixedfunction - thefunctions of the keys vary depending on the current activedisplay.Each display showsicons representingthe current softkey assignments at thebottom of the screen.To performthefunction representedby the icon, press thecorrespondingsoftkey.
A completeicon legendis providedin Section 5 -Reference.
3.3.6 New Positive Indicator
The New Positive Indicator is located on the left side of the Keypad/LCDDisplay,at the bottom.This light flashes redwhenever anewpositiveculture isdetected.The indicatorcontinues flashing until all positivevials are removed from theinstrument. RefertoSection 4.5 for information on removingpositivevials.
Ifthere is an audible alarm sounding, you can silence it by pressing theSILENCEALARM Key.
3.3.7 DOWN /UP ARROWKeys
The DOWN and UP ARROW keysarelocated on the left side oftheKeypad/
LCD Display. The DOWN ARROW key,representedby a down arrowhead, isused to decrease a displayed value, or to scroll downward inalist.TheUP AR-ROW key, represented by an up arrowhead, is used to increase a displayedvalue,or toscroll upward in alist.
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BACTEC°9050System User'sManual
3.3.8 Display Area
The Display area islocated at thecenter of the Keypad/LCD Display. It is used to
presentinformation toyou, and toshow thesoftkey definitions that allowyouto perform routineoperations.
The LCD Display is programmed to automatically dim after 5minutes of inactiv-
ity.To return the brightness tonormal, press one of the unassigned keys (such asthe rightmostsoftkey).
More information on displays is presented in Section 5 —Reference.
3.4 Door InterlockSwitch
When the door of the instrument is opened, a doorswitch senses the condition(seeFigure6).This switch tells the system to immediately stop the rotordrivemotor,start the door opentimer, and discard the results of any tests inprogress.
-I
Becausevial testresults oftests inprogress arediscarded when the door is
opened, door openings should be minimized ifpossible.
3.5 Floppy Disk Drive
The floppy diskdrive is located on the front of theinstrument, at bottom left. Itsprimary purposes are to enable you to save data to floppy disk, and to performsoftware updates when theyare released. See Figure 9.
3.5.1 Floppy DiskIndicator
TheFloppy Disk Drive Indicatorlightis on the left side ofthedrive below the
insertionslot. When off it indicates that no activity is occurring in thedrive.When on or flashing, it indicates that thedisk drive is accessing a floppy disk.Do
not attempt to eject afloppydisk whilethis indicator is lit.
26
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The floppy disk driveeject buttonis located to the lower right of the insertionslot.When a floppy disk isinserted fullyintotheslot, thisbuttonextends itself.Toremoveadisk, fully depress the eject button.Do not attempt to ejecta
floppy disk while thefloppydisk indicator is lit.
Figure 9 - FloppyDisk Drive Controls and Indicators
3.6 BarcodeScanner
The barcode scanner islocated to the rightoftheKeypad/LCD Displaymodule.When the dooris opened and an activity is initiated (e.g., entering newvials,removingpositivevials, etc.), thescanner turns on and isready to read a vialbarcode.
To scan a vial barcode, place the vial in the alignmentblock in front of thescanner.If necessary,rotate the vialslightly untiltheacknowledgment beep sounds (indi-catingthatthebarcode was scannedsuccessfully).
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BACTEC®9050System User'sManual
3.7 Audible Tones and Alarms
Eight different types of sounds are generatedby the BACTEC® 9050 instrumentas you perform operations. Each of the soundsis unique.These tonesare de-signed to keep youinformed about variousoperational states of theinstrument.
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Thissection describes routine operation of the BACTEC® 9050instrument.Thefollowingmajor topics arediscussed:
♦ PreparingSpecimens
♦ DailyChecks
♦ Entering New Vials
♦ Positive andNegativeSpecimens
♦ Printing System StatusReports
♦ Resolving Station Errors
♦ Identifying Anonymous Vials
Thesetopics areofferedina general logical orderwhich might fit the workflowof the average laboratory. Some of theoperations. such as daily checks, may bedone atyour convenience. Otheroperations, like monitoring the system for newpositives and alarm conditions, shouldbeongoingthroughout the day.
MA-0103-C)
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Specimensshouldbecollected aseptically from the patient and inoculated intothe vials. Refer to theappropriateMedia Package Insertfor specific recommenda-tions on specimencollection.Vials should be labeledandsenttothe laboratoryatonce.Additional information is alsoprovided in theBACTEC® BloodCollection
Instructions,MA-0 108.
Preparation
At leastoneaerobic culture vial and one anaerobic culture vialshouldbe pre-pared.To prepare a vial, remove the plastic flip cap and clean the exposedrubberseptum with 70%isopropyl alcohol. Use a separate swab for each vial.Inoculatethe vial withtheappropriate volume of sample (refer to theMedia PackageInsertfor specificinformation on vialinoculation).
4.2.1 Media QualityControl
Refer to the specificculturemedia package insert for Quality Control recom-mendations.
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4 -Operation
4.3 DailyChecks
Each day severalsimple system checks should be done.
The following checksshould bemade:
• Check the temperaturereadout on the instrument's LCDdisplay.Verifythat the temperature is currently at 35° C ±1.5° C.Also check thereading on the temperature QCvial. If the readings are not 35° C±1.5° C,refer to the instructions in Section 7 -Troubleshooting.
• Ifyouhavean optional printer,check its papersupply. If the papersupply is low or exhausted, replace the paper.
4.4 Entering New Vials
After specimens have beenprepared, theyshould be scanned and placed in theinstrument assoon as possible. However, all BACTEC®fluorescent series instru-ments(9240,9120,9050) have delayed vial positivity criteria that provide forroutine delays causedby vial transport,overnightlab closures,etc. Thesystemaccommodates the following delayconditions:
For Plus Aerobic/F, Plus Anaerobic/F, PEDS Plus/F, and Lytic/10AnaerobidFMediaTypes:
• Up to 20 hours if vials are incubated prior to entry in the instrument, or
+ Up to 48 hours if vials are not incubated (i.e., held at roomtemperature)
For StandardAerobic/Fand StandardAnaerobic/F MediaTypes:
• Up to 12 hours if vials are incubated priortoentry inthe instrument, or
• Up to 48 hours if vials are not incubated (i.e., held atroom temperature)
Before placing vials into the instrument, youshould always scan theirbarcodes
and placethem in their assignedstations through the vial entryactivity.Certain
media types use different positivitycriteria, and the system can only applythesecriteria if the vial label - inwhichthe mediatype is encoded - is scanned (or themediatypeis entered manually). In addition, if the vials are not assigned to theirstations prior to placement intheinstrument, they become anonymous vials, andmust be identified before other states (such aspositive, negative,etc.) canbedisplayed.Anonymous vial identification involvestheremoval and reinsertion ofvials,which canresultin an increase of false positiverates.Thereforeanonymous
vial loading into the instrument shouldbeminimized.
There are two ways to enter new vials into the instrument:
• By scanning the vialbarcodewhen the"barcode scanner ready"iconappears
♦ By manually selectingthemedium type ifthevial barcodecannotbe
scanned by pressing the "nobarcode" softkey
MA-01();±,-b
31
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Prior to placing vials into stations, visually inspect all vials for positives.Evidenceof microbial growth includes hemolysis, turbidity, and excess gas pressure (caus-ing the vialseptum to bulge outward).All such vialsshouldbe treated as posi-tives; they should be stained andsubcultured.
Toenternew vials in the instrument:
Take the newcultures to theinstrument.Opentheinstrument door. Follow theprocedureshownin Figure 10.
NOTES
When scanning vial barcodes, place the vial in thealignmentblock in front of the scanner with the barcode label facing thescanner. If necessary,rotate the vialslightly so the scannercanread the labei.The system beepsonce toindicate a goodscan.
32
Station assignmentsare calculatedby the system software to
balance the rotor. In order to maintain rotor balance,you
should always enter vials into the instrument as described in
Figure 10, and place the vialswhere the systemindicates.
When inserting vials into stations, carefully push the vial into
thestation. Press against the shoulders to insure that the vial is
fully seated in thestation.
Oncethe vialsare placedinstations, they should not be twisted
or turned.Vials should not be removedexceptin the following
conditions:
•Removal ofpositive
•Removal ofnegative
• Reassign if station becomes bad
• Identification of anonymousvials
Any vial reassigned to anewstation shouldbesubcultured
Many positivecultures will bedetected inthefirst24 hours after inoculation,butongoing negative vials must still be kept for severaldays toassuremaximumrecovery.With theBACTEC® 9050 instrument, vialsaretypically held for 5 - 7daysbeforethey are discarded as negative. Each laboratory shouldsetthe proto-col length based on its own policies andconditions.Your protocol length can befrom 4 - 7days.
AsubcultureandaGram stainshouldbe performed from eachpositive vial. In
most cases, organisms will be seen and apreliminary report can be made to thephysician.Preliminary antimicrobial susceptibilityandidentification proceduresmay also besetupfrom fluidin theculture vials.The resultsfrom these prelimi-narytests should beconfirmed by using standardized laboratoryprocedures.
The system allows re-entry of instrument-positive vials for up to3hours aftertheir removal (subjecttotheconditions described in Section 4.5.3).The re-entryfeature resets positivity routines, retains previous test readings, and continues totestthe vial as an ongoingculture.
For a maximumyieldof isolates, negative cultures may be stained and/or subcul-
tured during the testperiod or immediately prior to theirdisposal.
4.5.2 Notification of Positive and Negative Vials
The systemnotifies you of new positive cultures in severalways:
♦ New Positive indicator lamp on the front of the instrumentflashes.
♦ On the Main Status display, the station is displayed as a filledcirclewith
a plus sign (+) in it, and the positives total in the Summary reflects the
number of positives in theinstrument.
♦ When the door is opened, the"removepositives" softkey appears in
thesoftkey assignment area of the LCDDisplay.
♦ Until silenced, the audible alarm sounds (ifenabled).
Negativecultures mayexist as ongoing negatives (in protocol) and out-of-proto-col negatives.Youare notified of these conditions asfollows:
♦ OngoingNegatives - On theMain Status display, the station is dis-
played as a filledcircle.
♦ Out-of-Protocol Negatives - On the Main Status display, the station is
displayed as a filled circle with a minus sign (-) in it.Also,thenegativescount in theSummary reflects the number of final negatives in theinstrument. No audible alarm sounds for notification.When the dooris opened, the "remove negatives" soft key appears in thesoftkey as-signment area of the LCDDisplay.
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4-Operation
4.5.3 Removing Positive Vials
Pressthe SILENCE ALARM key to silencethe audible alarm. Openthe instru-ment door. Followthe procedure shown in Figure I I.
Press"removepositives" softkey
se
If vial was originally entered by scanning Ifvial was originally entered manually (by selec-barcode, the following display appears: ting media type), the following display appears:
+?Loaaek4
1 lee
or 1111
Repast unti elpeintives are removed.Thin press `exitsoft key.
•
Figure 11 - Removing Positive Vials
+A A22 MI6
°
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The New Positive indicator remains lit until all newpositivevialsareremovedthrough the Remove Positivesoperation.
Instrumentpositive vials can be returned to the instrument for
additionaltestingsubjecttothe conditions described below.
Returning Positive Vials to the Instrument for Further Testing
The systemallows you to return a pulled positive vial — if the vial wasoriginallyscanned into the instrument —for up to3hours after removal (or until thevialgoes out of protocol, whichever isearlier).The re-entry feature resets positivityroutines, retains previoustest readings,and continues to test the vial as an ongo-ingculture.Ifthe vial is not returned within the 3-hour re-entry window, previ-oustest results are discarded. If the vial was manuallyentered (by selecting me-dia type), the systemtreats it as a new vial if it is removed and subsequently re-entered.
Thefollowingprecautions should be observed when using the vial re-entry fea-ture. Instrument-positive vialsshould besubcultured and Gram stained upon
removal from theinstrument. Even thougha3-hour re-entry window exists for
the return ofavial to an ongoing status, thevial should be returned to the
instrument as soon as possible.Vialsshould remain at room temperature while
they are out oftheinstrument.
To return apulledpositivevial to the instrument for furthertesting, open the
door. Press the "vial entry" soft key. Next scan the vial's barcode label. Place thevial in theindicated station(this may differ from theoriginalstation).Previoustest results are retainedonly in the followingcircumstances:
♦ Youoriginally scanned the vial barcodewhenentering it in the instru-
ment.
• You returnthevial withintherequired timeframe.
♦ You scan the vial label to re-enterthevial.
* You return the vial to the same instrumentfrom which it wasremoved.
If you do not usethevial entryactivity to re-enter the vial, it becomes Anony-mous at the nexttest cycle, andtheprevious testresults are removed from thedatabase if it is not identified within the 3-hourperiod.
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4 -Operation
4.5.4 Removing Negative Vials
Open the instrument door. Follow the procedure shown in Figure 12.
Press "remove negatives"soft key
■
If vial was originallyentered by scanningIf vial was originally entered manually (byselecbarcode,the following display appears: ting media type), the followingdisplayappears
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13ACTEC®9050System User'sManual
4.6 Printing System StatusReports
If yoursystem is configured with an optional printer,youcan printaSystemStatus Report thatprovides information about current and recentlyremovedculture vials.The report isdividedinto three mainsections:the top section con-tains information about theinstrument, themiddle section containsinformationon vials currently in theinstrument, and the bottomsectioncontains informa-tion on vials removed in the past24hours.
The topsection presents the following system/instrumentinformation:
♦ ReportName
♦ ProductName
♦ Date and time that the report wasrequested
♦ Instrument number
♦ Incubatortemperature
♦ Systemsoftwareversion
♦ Ring status (E indicates good, X indicates bad , and ? indicates an un-
knownstate)
The middlesection (Current Vials)presents the following information onvialscurrently in theinstrument:
♦ Station Number(the sort order of the report)
♦ Vial Barcode Sequence Number(if vial was entered manually by select-
ing mediatype, the last 8 digits are indicated with hyphens; digits 3 and4 indicate the selected or scannedmediatype)
♦ Vial Status (+ indicatespositive, = indicates ongoing,_ indicates nega-
tive, ?indicates anonymous [Sequence Number appearsblank], and !indicates error)
♦ Start ofProtocolDate andTime
♦ Protocol Length
♦ End Date andTime (for positives, the Date and Time that system flagged
positive; for negatives, the end of protocol Date and Time;for ongoing,error, and anonymous,blank)
♦ Time to Detectioninhours and hundredths of hours for positivevials
The bottom section (Removed Vials)presents ali of thefields named directlyaboveexcept Station Number.Vials that have been removedfrom the instrument
in the 24hours preceding thereport request timeare includedinthis section.
38
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In order for the report to print correctly,you must set your printer to skipprinting across the perforation. Consult your printeroperating manual for in-structions on how tosetthis feature in the printer.
To Print the System Status Report
FromtheMain Status Screen, press the "print report" soft key.The iconappearson the display only if a printeris attached to thesystem, is turned on, and isonline.
01 I System Status Report 10
01 Becton Dickinson BACTEC 9050 i ()
L Datehime Instrument Tem_perature Version Rini GA: A B C
iv1 12/16/96 11:34 1 35.0° C V1.00A a X a
01 Current Vials IC
0 'Station Sequence #
1 All 000000001313
()I ;',1223 000000003712
c)! 2: 0000
01
000000006397
000000006543
I B26 000000009449
01
Seguence # Status Start date/time Protocol
01
000000006111 _ 12/10/96 13:13 5000000007654
I
0,
Status Start dateitime Protocol
_
12/11/9611:22
!
12/13/9611:23.2/14/96
=
-12/14/9622:34+12/14/9622:34?
12/15/9615:16
22:33
I+
Removed Vials (24
+ 12/13/9621:12512/16/9621:34 72.37
Enddatelime
512/16/965
5
12/16/96
5
TTD (tours)..1 0
11:22
10:34
Hours) L,
End date/time TTD (ours)'
12/15/9613:13 -I 0
36.00
10
li
,...)
I
0
MA-0103-5
Figure 13 - System Status Report
39
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Asyou performactivities at the BACTEC' 9050 instrument, and asvialtestingprogresses, system alerts and errorsmay occur. Differenttypes ofalerts anderrorsare flagged by either"E" error codes, audible tones, the System Alerticonappearing, or the System Alert indicator flashing (or a combination ofthese).
Generally, the moreserious the condition, the more ways thesystem notifies
you of theproblem.
CAUTION
When the system notifies you of alerts and errors, you
should immediately respond to the condition.
Systemalerts, whichcompriseall"E" type error codesexceptthosein the30's,are reported in the system alert log.These errors cause the system alert icon toappear on the Main Status screen, and canbereviewed by pressingthe"systemalert" soft key.The errorsmust be reviewed toclear the system alertcondition.
Activity errors (such as scanning anunexpected barcode) cause theactivity er-
ror icon to appear on theactivity screen (e.g.,remove positives, remove nega-tives, etc.).They do not put the system into an alertcondition, and canfrequently
be cleared by simplyperformingtheactivity correctly (such as scanning the cor-
rectbarcode).
Station errors (type E12) can occurfrom a number of causes.These errorsare
reported in the system alert log, andarealso flaggedby the appearance of the
resolve errors icon on the Main Activity screen.The general operation of resolv-
ing errorstations isshownin Figure14.Specific suggestions forresolving error
stationsareprovidedin Section 7.2 - Error Messages, under errorcodeE12.
Allthe"E"type error codesare discussed in detail in Section 7.2 - Error Mes-
sages.The audible tones are discussed in Section 3.7 -Audible Tones andAlerts.
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BACTEC® 9050System User'sManual
4.9 Power Failures and ManualOperation
The information in the systemis stored in memory until a power failureoccurs.When a power failure occurs, the data istransferredintonon-volatile RAM. Datain NVRAM is maintained by a long-life battery.After the data istransferred,thesystem iscompletely shut down. No vialtestingoccurs until power isrestored.
When power isrestored, thetimes thatpower waslost and restoredarenotedin the system alert list and canbeviewed on the display (note that if multiplepowerfailures occur, only the latest is retained in the alert list). Culturevialtesting resumes when power isrestored.
For theperiod of time that power is out, the system missesonetest reading foreach tenminutes of power outage. Althoughunlikely, missed readings can resultindetection failures.Therefore if testing is interrupted for longer than forty min-utes, toensure maximum recovery it is recommended that you perform a sub-cultureonongoing culturevials.
You may, at your option, connect the system to an UninterruptiblePower Supply(UPS). Use of a UPS may helpprevent interruptions to testing, or - if the UPS isconnected to an emergency power line - the necessity of subculturing vials inthe event of a sustained powerfailure.
•
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BACTEC°9050System User'sManual
5.2 Software Menu Tree
The following is a hierarchical list of ail displays/functions in the system. Thesections where these activities are discussed in detail are notedinparentheses.
Main Status Screen (Door Closed)
Configuration
Set Test Protocol Duration (Section 2.4.2)
Set Time Format and/or Time (Section 2.4.2)
SetDate Format and/orDate (Section 2.4.2)
Set Audible Alarm Volume (Section 2.4.2)
Set Instrument Number (Section 2.4.2)
SetDVE (Delayed Vial Entry)Media Threshold (feature not availablefor useinthe USA; international users refer to MA-01 I3,BACTEC®
9050 Delayed Viol EntryInstructions)
Set Languagefor Report (Section 2.4.2)
WriteDatato Disk (Section 2.4.2)
Update Software (Section 2.4.2)
Print Report (Section 4.6)
Review System Alert List (Section 4.7, 7.2)
Main Activity Screen (Door Open)
Vial Entry (Section 4.4)
Remove Positives (Section 4.5.3)
Remove Negatives (Section 4.5.4)
Identify Anonymous (Section 4.8)
Resolve Station Errors (Section 4.7,7.2)
5.3 Display Types
There are two main types of display screens.When the instrument door is closed,the Main Status screen (Section 5.3.1) is displayed. When the door is open,theMain Activity screen (Section 5.3.2) is displayed.
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TheMain Statusscreen (Figure 16) is displayed when the instrument door isclosed.This screenpresents up tothree iconsrepresenting softkey definitionsthat allowyou to perform system level activities.Theseicons are asfollows:
♦ The "configuration" icon, where you can access seven setup parameters, the
write data todisk function, and the updatesoftwarefunction.
♦ The"print report" icon.This icon appears only if you have an optional printer,
it is attached,turnedon, and online.
♦ The "review system alert" icon, which allows you to review anysystem
alerts that may haveoccurred or that maystill exist.
In addition, system and station status information is always inview.Thefollowinginformationis presented:
♦ Current date
♦ Currenttime
♦ Current instrumenttemperaturein degrees and tenths of degreesCelsius
♦ Summaryregion, showingnumber of vials thatare positive, negative, ongo-
ing, available, and stations that are in error, anonymous, orblocked (notethatsummary counters may total greater than 50 because vialscanhavemultiplestatuses)
♦ Rotor representation,showing the locations of the variousvialstatuses
when the rotor is in the "home" position (with the temperaturestandardsat the 12:00position)
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BACTEC® 9050 System User'sManual
5.3.2 Main ActivityScreen
The Main Activityscreen (Figure 17) is displayed when the instrument door isopen.This screen presents up to four iconsatatime representingsoft key defi-nitions thatallowyou to perform vial- andstation-related activities.Theseiconsare asfollows:
♦ The "vial entry" icon, which allows you toenter newculture vialsfor testing.
♦ The "removepositives" icon. This icon appears only if there arepositive
vialsintheinstrument. It allowsyou toremove thesepositivevials.
♦ The"remove negatives"icon. This icon appears only if thereare final (out-
of-protocol) negative vialsintheinstrument.Itallows you toremovethese
negativevials.
♦ The "identify anonymous vials" icon. This icon appears only if thereare
anonymous vials in the instrument. Itallows you to identify these anony-
mous vialsso that the system canapply the correct positivity criteria and
display anyunderlyingstatuses.
♦ The "resolve station errors"icon.This icon appears only ifthereare error
stations in the instrumentandthereare no anonymous vials.Itallows youtoresolvethe errorstations.
In addition, system andstation status information is always in view.The followinginformationis presented:
♦ Current date
♦ Currenttime
♦ Current instrument temperature in degrees and tenths of degreesCelsius
♦ Summary region, showingnumber of vials thatare positive, negative, ongo-
ing, available, and stations thatarein error, anonymous, orblocked (note
thatsummary counters may total greater than 50 because vialscanhave
multiplestatuses)
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The BACTEC® 9050instrument requires minimal maintenance from theuser toprovide reliable performance. Daily verifications include: checking the incubator tem-perature and printer paper supply(if configured). Routine preventivemaintenanceconsists only of amonthly changing or cleaning of the cabinet air filters.All otherprocedures are on an "as needed" basis.Any maintenance or repair not described inthis section should be performed by Becton Dickinson personnel only.
Note that iftesting is interrupted for longer than fortyminutes in performingany maintenance procedure. toensure maximum recovery itis recommendedthatyou perform a subculture on ongoing culturevials.
A thermometer and special vialare provided for temperatureverification (QC)of instrument incubation. It is recommended that the accuracy of the thermom-eter be verified against a calibrated lab thermometertoinsurethevalidity ofthetemperatureverification.
The temperature control circuitry is designed to maintainthecabinet tempera-ture at 35° C ±1.5° C. If your manual reading is within 1.5° C of thesetpoint(35°C), the controller andheaters are operating within theirspecifications.
The temperaturevial is mounted in a bracket on theinside of the instrumentdoor (see Figure2).
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Thereare no user-serviceableparts in the barcode scanner. The only requiredperiodic maintenance is to clean the scanner's window.To clean thewindow,usea damp, lint-free, non-abrasive cloth. Dry the window with a dry lint-free non-abrasivecloth.
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MA-0103-E3
6 -Maintenance
6.2.4Decontamination
A situation requiringbiological decontamination of one or morestations canoccur at any time.The priority in thissituationis to first limit the extent of thecontamination and then todecontaminate the station orreplace the rotor ifcomplete decontaminationcannot be accomplished.Ifthere any doubts that theaffectedstation(s) cannot becompletely decontaminated,the rotorshouldbereplaced.
To Decontaminatea Station or Rotor
The solutionrecommendedto clean the affected surface should be at least a I 0per cent household bleach solution.All surfacesmust bethoroughly washed withthefreshly prepared bleach solution so the surfacesare "glistening wet" Ifyouare notsure of the extent of the contamination, thoroughlywash the entireexterior of the Rotor with thefreshly prepared bleach solution. Proceed in the
followingmanner to decontaminate a station or Rotor if a vialshouldbreak in a
station.
1 Wear gloves and a gown, completelycovering any body surfaces thatcould
possibly come in contact with the affected instrumentsurfaces.
2 Carefullyremove broken glass with forceps, one piece at atime.
TheBACTECa 9050 instrument has been designedandtested for troublefreeperformance. However, in the event of amalfunction, most of the majorsystemcomponentscan bereplaced. Procedures for removing and replacing compo-nentsareprovided in the sections that follow.
Replacement modules may be swapped for failedmodules which are then re-turned to Becton Dickinson. Credit is then applied towards thereplacementmodule. Only replacement parts supplied by BectonDickinson should be used intheprocedures describedinthis section.
Modulereplacementinstructions are organized in the followinggroups:
Front CabinetComponents (Damper Cylinder, Door Sensor Switch, Rotor, RTD
[temperaturesensor]) - Section 6.3.1
Front Panel Components (Barcode Scanner, Floppy Disk Drive,Keypad/LCD
Display) - Section 6.3.2
Rear CabinetComponents (AC and DC Power Distribution Boards,Blower,
The RTD (resistance temperature device, ortemperaturesensor) is located be-hind the rotorontherightside (facing the front).Toremovethe RTD, follow thesteps below and refer to Figures 24, 25, and 26.
Required Materials
Small PhillipsScrewdriver
ToRemovetheRTE)
1 Remove the rotor (Section 6.3.1.3) and rear cabinet shell (Section6.3.3.1).
2 Unscrew the smallphillips screw on the blackmountingclip.
3 Push the rubber grommet in the through-hole through to the front of the
instrument.
4 Unplug themaroon 3-wire connectorfrom the I/O Board (locatednear the
front end of the I/OBoard).
5 Feed the RTDcablethrough the through-hole to the front of the instru-
ment andremove the RID.
6 Replace the RTD by reversing the above steps. Be sure to replace the rub-
The front panel,which islocatedat the bottom oftheinstrument,must be re-moved to replacetheBarcode Scanner, Floppy Disk Drive, or Keypad/LCD Dis-play.Refer to Figures 27 and 28.
Required Materials
Medium PhillipsScrewdriver
Small FlatheadScrewdriver
ToRemovethe FrontPanel
1 Unscrew the two phillips screwsunder theKeypad/LCDDisplay.
2 Disconnect the wide flat ribbon cable by pulling outward on the tabs at the
connector's end.
3 Disconnect the d-shaped connector (use the small flathead screwdriver to
loosenthescrewlocks).
4 Disconnectthebarcode scanner andremove the panelassembly.
5 Replace the front panel by reversing the above steps. Be sure to reattach all
cables when replacing the front panel.
Figure 27 - FrontPanel Removal(A)
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7 Beforeattachingtheflat ribbon cable, youmust identify Pin I on thedisk
drive. Locate the cable socket on thedrive assembly. Locate the pins on theprinted circuit board thatcorrespond to the pins of the cable socket. Lo-cate thePin Idesignation(marked by white number "I ") on the printedcircuit board (not the connector). Align the dark blue strand of the flatribbon cable with Pin I of the printed circuitboard, andpluginthecable.
Note that in most cases,thedark bluestrandwill beoriented at thecenterof the board. However , this orientation canvary among different diskdrivemanufacturers. It is important toverify thelocation of Pin I onthedrive'spc board. If necessary,you can peel theplastic shield away from the diskdrive (asshownin Figure 31) to see better.
.3 Insert the new drive/bracket andtightenthefasteners.
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6 - Maintenance
6.3.3 RearCabinetComponents
6.3.3.1 Rear CabinetShell
Therear cabinet shell must be removed to gain access to the followinginternalcomponents:AC and DCPower Distribution Boards, Blower, ComputerBoard,Detector Board, Fan, Heater,I/OBoard, Main Transformer, On/Off Switch,+5V/± I 5V and40V Power Supply Boards, RTD. See Figures 34 and 35,
Required Materials
Medium PhillipsScrewdriver
ToRemovethe Rear CabinetShell
1 Therear cabinetshell is held to the instrumentframeby 5 phillipsscrews
with flatwashers.
2 There is onescrew on each side of the instrument toward the bottomrear.
Removethesetwoscrews and flatwashers.
3 The other three screwsare on the rear ofinstrument. One is at the top
center oftherear panel.There is also one screw on the far right of the rearpanel and one on the far left, approximately halfway down. Removethesethree screws and flatwashers.
4 Lift the rearcabinet shell off theframe.
Figure 34 - Rear CabinetShell Removal (A)
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6 -Maintenance
6.3.3.2 ElectricalGuard
Theelectrical guardmust beremoved to access thePower Supply Boards, theAC and DC Distribution Boards, and the MainTransformer.Toremove theguard,follow the steps below and refer to Figure 36.
Required Materials
Small PhillipsScrewdriver
ToRemove the ElectricalGuard
I Remove the 2 small phillipsscrews from the top edge oftheguard.
2 Remove the smallphillips screw from the lower rear edge oftheguard.
3 Lifttheguard up as far as possible,thenmove itrearwardaway from the
instrument.
4 Replace the guard by reversing the above steps. DO NOTOVERTIGHTEN
THE SCREWS WHEN REPLACING THEGUARD.
Figure 36 - ElectricalGuard Removal
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The ACPower DistributionBoard islocatedin the rightelectronics compart-ment (facing the rear). It is mounted vertically, andcontains four large relays andtwo large transformers.Toremovetheboard, follow the steps below and referto Figure 37. Fuses Fl and F2 are TypeT(slowblow) rated 100 mA,250VAC.
Required Materials
5/1: Hex Nut Driver
To Replace theACPower Distribution Board
1 Remove therear cabinet shell as describedinSection6.3.3.1.
2 Remove the ElectricalGuard as described in Section 6.3.3.2.
3 Rock out the two cable connectors at the bottom right of theboard.
4 Squeeze the tabs and rock out the cable connector at the bottom left of the
board and the cable connector at the far left of theboard.
5 Disconnect the cable at the top right of the board by pulling outward on the
tabs toloosenit, then pull the cable free of theconnector.
6 Remove thesix nuts that hold theboardto the chassisupright andremove
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6-Maintenance
6.3.3.4Blower
The blower islocated to the left ofcenter facing the rearoftheinstrument.Itisa large cylindricalblack module.To remove the blower, followthesteps belowand refer to Figure 38.
Required Materials
Small PhillipsScrewdriver
To Replacethe Blower
1 Remove the rear cabinet shell as described in Section 6.3.3. 1 .
2 Unplug the largeblack cable from the bulkhead fitting.
3 Remove the four small phillipsscrews that hold the blower assembly in
place andremovethe blower.
4 To replace the blower, reverse the abovesteps.
Figure38- slowerRemoval
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The computerboard is a small piggyback boardmountedat the rear of thelarger
I/OBoard on the bottom of the leftelectronics compartment. To remove thecomputerboard,followthe steps below and refer to Figure 39.
Required Materials
No tools required
To Replace the Computer board
1 Remove therear cabinet shell as describedinSection6.3.3.1.
2 You canremovethe computer board withoutremovingtheI/Oboard,but
it is easier and safer to replace the computerboard with the I/O board outof the instrument See Section 6,3.3.10 forinstructions on removing the I/Oboard.
3 Disconnectthethree ribbon cables on the front sideoftheboardby rock-
ingthem off.
4 Disconnect the ribbon cableonrear side ofboard.
5 Lift the computer board up off the I/Oboard.
6 Replace the computerboardby reversing the abovesteps.Whenreplacing
the computerboard,note that itfits on the I/Oboard in one orientation
only. Besure to carefully align the computerboard's pins with thesockets
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BACTEC®9050System User'sManual
6.3.3.8 Fan
To replace the fan, follow the steps below and refer to Figure 42.
Required Materials
Small PhillipsScrewdriver
To Replace the Fan
1 Remove therear cabinet shell as describedinSection6.3.3.1.
2 Unplug the twoquick disconnectwires on theright side of the fanassembly.
Notethatthegray wireis attached to therear terminal, and the blue wireis attached to the frontterminal.
3 Disconnect the ground wire on the top of the fan assembly.Unscrew the
small phillips screw, andremove it and the flatwasher.Theringterminalisattached tothegroundwire, and beneath it is anexternal star washer.Savethis mounting hardware for reattachingtheground wire later.
4 Remove the four small phillips screws that hold the fan to the chassis and
remove the fan.
5 Replace the fanby reversing the above steps. Besure you place one finger
guard on each side of the fan itself.Also be sure to replace the hardware and
wires in the following order: theexternalstar washer, thegroundwireringlug, the flat washer, andthephillips screw.
Figure 42 - Fan Removal
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