摘要
目的评价BD BACTEC 9240全自动血液培养系统检测血流感染病原菌的影响因素。方法回顾性调查BD BACTEC 9240全自动血液培养系统的检测结果,分析双侧血培养的检出率;体外模拟血培养评价抗菌药物治疗浓度及送检时间对血培养结果的影响。结果双侧血培养可以提高血流感染的检出率;体外模拟血培养结果显示,大肠埃希菌和金黄色葡萄球菌在庆大霉素、头孢噻肟、万古霉素、哌拉西林/他唑巴坦及左氧氟沙星的治疗浓度中能被检测,在亚胺培南的治疗浓度中不能被检测;肺炎链球菌在所选抗菌药物的治疗浓度中均不能被检测;送检时间不会影响血培养的检测结果,但会缩短血培养的阳性检测时间(TTD)。结论双侧血培养能提高血流感染的检出率;抗菌药物治疗浓度会抑制血培养中部分病原菌的生长而导致假阴性;送检时间不会影响血培养的检测结果,但会改变TTD;TTD易受多种因素影响而不能反映血流感染的带菌量。
Objective To evaluate the influence factor on pathogen detection of blood stream infection by BD BACTEC 9240 automated blood culture system.Methods The results of BD BACTEC 9240 automated blood culture system was studied retrospectively,and the pathogen detection rate in double sets of blood culture was analyzed.The influences of antibiotic therapeutic concentration and delivery time were evaluated in simulated blood cultures in vitro.Results Double sets of blood culture can increase the detection rate of bloodstream infection.Escherichia coli and Staphylococcus aureus could be detected in therapeutic concentrations of gentamicin,cefotaxime,vancomycin,piperacillin/tazobactam and levofloxacin in simulated blood cultures in vitro,but be not detected by imipenem therapeutic concentration.Streptococcus pneumoniae was inhibited by the selected antibiotic therapeutic concentration.Delivery time would not affect the pathogen detection,but decreased the time to detection（TTD） in blood cultures.Conclusions Double sets of blood culture can increase the detection rate of bloodstream infection.Antibiotics would inhibit some pathogen growth in blood cultures,leading false negative.Delivery time would not affect pathogen detection,but would change TTD.TTD is effected by many factors,could not be a surrogate for the initial bacterial concentration in bloodstream infection.
出处
《检验医学》
CAS
2013年第7期606-610,共5页
Laboratory Medicine
关键词
血流感染
血培养
阳性检测时间
抗菌药物
治疗浓度
Bloodstream infection
Blood culture
Time to detection
Antibiotic therapeutic concentration
