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Dear Mitzi:
It is clear that more organisms will be isolated when an enrichment broth is used. This was pointed out by an article by L. Barth Reller in J of Clin Micro. vol 33:161-165. He showed that certain organisms would be found in the both and considered "true" infective agents. On the other side of the coin, the majority of isolates from broth enrichment were considered contaminants (73%). Of the 97 patients with true infections from broth enrichment only, 61% of the patients were already on therapy. His conclusion was that broth enrichment did not favorably alter patient management.
I would discuss this study with ID and pathology to make sure that they are comfortable with not using them. Clearly, there were in Dr. Reller's study, organisms that broth enrichment revealed that were the causative agent of disease. However, the information did not impact patient care.
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