摘要
目的评价BACTEC Plus需氧瓶、BACTEC Lytic溶血素厌氧瓶的血培养系统和BacT/Alert FA需氧瓶、BacT/Alert FN厌氧瓶的血培养系统对临床菌血症血标本的检测能力。方法回顾性研究。对北京大学人民医院2013年6月至2015年9月收集的同一住院患者、同一时刻采集的4瓶血培养标本（BACTEC Plus需氧瓶、BACTEC Lytic溶血素厌氧瓶和BacT/Alert FA需氧瓶、BacT/Alert FN厌氧瓶各1瓶）进行分析。全部血培养瓶用BACTEC FX和BacT/Alert 3D全自动血培养仪培养5 d。用χ2检验比较不同血培养系统检测不同病原菌临床血标本的阳性率，平均检测时间（TTD）应用配对符号秩和检验。结果2 189组标本中，20组因抽血量不足剔除，201组（9.27%）为菌血症阳性。除去假阳性及污染的病例，对于不同病原菌，BACTEC Plus需氧瓶和BacT/Alert FA需氧瓶阳性率（单瓶分离菌株数/需氧瓶总分离菌株数）分别为75.3%（140/186）、69.4%（129/186）（χ^2＝1.625，P＝0.202），BACTEC Lytic溶血素厌氧瓶和BacT/Alert FN厌氧瓶阳性率（单瓶分离菌株数/厌氧瓶总分离菌株数）分别为63.6%（77/121）、81.8%（99/121）（χ^2＝10.083，P＝0.001）。BACTEC Plus需氧瓶平均TTD 11.0（8.0～16.0）h与BacT/Alert FA需氧瓶13.9（10.4～18.7）h的差异有统计学意义（Z＝－5.240，P〈0.001），BACTEC Lytic溶血素厌氧瓶平均TTD 8.0（7.0～10.0）h与BacT/Alert FN厌氧瓶11.3（9.3～12.7）h的差异有统计学意义（Z＝－4.299，P〈0.001）。与两系统各抽1套相比，单独抽取1套BACTEC系统或BacT/Alert系统血培养瓶只能分别检出74.13%（149/201）和74.63%（150/201）的阳性标本。结论BACTEC血培养系统的需氧瓶和厌氧瓶相比BacT/Alert系统具有更快的TTD和更低的假阳性率，对于不同病原菌检测能力差异无统计学意义。BacT/Alert FN厌氧瓶阳性率高于BACTEC Lytic溶血素厌氧瓶。
ObjectiveTo evaluate the clinical performance of the BACTEC Plus aerobic, BACTEC Lytic anaerobic, BacT/Alert aerobic and anaerobic blood culture media in detection of bloodstream infections.MethodsRetrospective study was conducted. A total of four blood culture bottles from each inpatient with suspected bloodstream infections were collected and analyzed from June 2013 to September 2015 in Peking University People′s Hospital. The four bottles, including BACTEC Plus aerobic, BACTEC Lytic anaerobic, BacT/Alert FA aerobic and BacT/Alert FN anaerobic media, and was incubated for 5 days in the BacT/Alert 3D and BACTEC FX instruments, respectively. Time to detection （TTD） and positive rate in detecting bacteria of the two systems were evaluated by Wilcoxon test and Chi-square test.ResultsAmong 2 189 total cultures collected, 20 were excluded because of blood shortage and 201 （9.27%） were positive for pathogens. The positive rates of BACTEC Plus aerobic media and BacT/Alert FA aerobic media were 75.3% （140/186） and 69.4% （129/186） （χ^2=1.625, P=0.202）, respectively. While, the positive rates of BacT/Alert FN anaerobic media and BACTEC Lytic anaerobic media were 81.8% （99/121） and 63.6% （77/121） for total organisms, respectively （χ^2=10.083, P=0.001）. A significant difference in TTD was detected in BACTEC Plus aerobic media[11.0 （8.0-16.0） h]and BacT/Alert FA aerobic media[13.9 （10.4-18.7） h]（Z=-5.240, P〈0.001）. BACTEC Lytic anaerobic media[8.0 （7.0-10.0） h]had a shorter TTD （Z=-4.299, P〈0.001） than BacT/Alert FN anaerobic media[11.3 （9.3-12.7） h]. The positive rates of BACTEC and BacT/Alert system were 74.13% （149/201） and 74.63% （150/201）, respectively, compared with taking one set from each system.ConclusionsBACTEC media has a shorter TTD and almost the same bacterial recovery, and lower false positive rate than the BacT/Alert media.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2017年第4期303-308,共6页
Chinese Journal of Laboratory Medicine
关键词
菌血症
血培养
细菌
培养基
评价研究
Bacteremia
Blood culture
Bacteria
Culture medias
Evaluation studies
