摘要
目的：评价法国生物梅里埃公司Bact／ALERT 3D全自动血培养仪阳性结果中病原菌分布及假阳性报警率，以指导血培养结果的正确解读。方法对2013年8－10月的血培养仪阳性报警瓶进行转种培养，采用VIT EK‐2 Compact全自动细菌鉴定仪进行分离菌的鉴定，分析分离菌的种类、假阳性报警率及原因。结果224瓶阳性报警瓶中菌株分离阳性191瓶，总阳性率为85．27％，假阳性报警率为14．73％；所分离出的病原菌中，肠杆菌科细菌占首位为68．06％，其次为葡萄球菌属、非发酵菌和链球菌属，分别占16．23％、8．38％和2．62％；分离菌报阳时OD值＞4000占55．80％，OD值3000～4000占33．93％，OD值2000～3000占10．27％；标本阳性报警1 d内出现占73．66％，2 d内出现占90．62％，3 d内出现占93．75％，3 d后才出现占6．25％。结论肠杆菌科细菌和葡萄球菌属是引起菌血症和败血症发生的主要病原菌，为减少假阴性结果的产生，应加长培养时间，至少培养3d ，并察看OD值曲线状态有助于判断假阳性。
BJECTIVE To observe the distribution of pathogens cultured positive in Bact/ALERT 3D automatic blood culture system of BioM＆#233;rieux ,France and analyze the false positive alarm rate so as to provide guidance for the interpretation of results of blood culture .METHODS From Aug 2013 to Oct 2013 ,the positive alarmed bottles for blood culture were switched to blood agar for cultivation ,then the isolated pathogens were identified by using VIT EK‐2 Compact automatic bacteria identification system ,and the species of the isolated pathogens ,false posi‐tive alarm rate ,and causes were analyzed .RESULTS Of 224 bottles of positive alarm ,191 bottles were positive for the isolation of strains with the total positive rate of 85 .27% ,and the false positive alarm rate was 14 .73% .A‐mong all the isolated pathogens ,the Enterobacteriaceae ranked the first place （68 .06% ） ,followed by the Staphy‐lococcus spp （16 .23% ） ,non‐fermenting bacteria （8 .38% ） ,and Streptococcus spp （2 .62% ） .When the bottles a‐larmed ,the OD value of culture was different ：55 .80% cultures were more than 4 000 ,33 .93% cultures were be‐tween 3 000 and 4 000 ,10 .27% cultures were between 2 000 and 3 000 .The rates of positive alarm were impart in different culture time ：it was 73 .66% within one day ,90 .62% within two days ,93 .75% within three days , 6 .25% after three days .CONCLUSION Enterobacteriaceae and Staphylococcus spp are the predominant pathogens causing bacteremia and septicemia .To reduce the false negative results ,it is necessary to extend the time of culti‐vation for at least 3 days and observe the OD value cure ,which may facilitate the prediction of the false positive .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第22期5519-5521,共3页
Chinese Journal of Nosocomiology
基金
云南省科技计划基金资助项目(2011FB217
2011FB216)
关键词
血培养
病原菌
光密度
假阳性报警
Blood culture
Pathogen
Optical density
False positive alarm
