BacT/Alert 240全自动血培养仪的临床应用及评价

目的：评价全自动血培养仪BacT/Alert 240的临床应用情况，方法：回顾性分析BacT/Alert240全自动血培养系统检测7124份标本的阳性率，阳性检出时间，细菌种类以及假阳性率，假阴性率和污染率，结果：7124份血培养分离到804株微生物，其中细菌764株，阳性率11．5％，最快阳性检出时间2小时，24小时内检出的阳性占69．9％，48小时内占87．3％，72小时内占91．3％，804株细菌分布于24个属，假阳性率4．9％，假阴性率0．4％，污染率0．3％，结论：BacT/Alert 240全自动血培养仪提高了血培养的阳性率，缩短了阳性检出时间，检出细菌种类多尤其是苛养菌阳性率增加，减少污染机会，而且操作简便，结果快速，准确。     

BacT／Alert240全自动血培养仪临床应用评价

目的 评价BacT/Alert 240全自动血培养仪的临床应用情况.方法 回顾性分析应用BacT/Alert 240全自动血培养仪检测的1898份血标本,对检出阳性的时间、细菌种类和阳性率进行了评估分析.结果 1898份血标本分离出255株病原微生物,阳性率为13.4%.最快阳性检出时间为2 h,24 h内检出的阳性数占722%,48 h检出的阳性数占92.6%.假阳性率为3.1%,假阴性率为0.3%.结论 应用BacT/Alert240全自动血培养仪提高了血培养的阳性率.缩短了阳性检出时间,检出细菌种类多,而且操作简便,结果 快速、准确.     

ESP全自动血培养仪的临床应用及评价

目的评价ESP全自动血培养仪(简称ESP)临床应用情况。方法用ESP检测2147份血标本,观察其阳性检出率、检出时间,并对所检出细菌的种类及阳性率进行分析。结果2147份血标本中ESP提示阳性322例,分离出294株细菌,阳性率为13．7％,最快检出时间为2h,24h内检出的阳性数占60．5％,48h内检出的阳性数占83．3％,72h检出的阳性数占99％。假阳性率为0．87％。未发现假阴性。结论应用ESP有较高阳性检出率,缩短了培养时间,增加了检出细菌的种类,结果快速、准确。     

ESP全自动血培养仪的临床应用及评价

目的　评价ESP全自动血培养仪(简称ESP)临床应用情况。方法　用ESP检测2147份血标本,观 察其阳性检出率、检出时间,并对所检出细菌的种类及阳性率进行分析。结果　2147份血标本中ESP提示阳性 322例,分离出294株细菌,阳性率为13.7%,最快检出时间为2h,24h内检出的阳性数占60.5%,48h内检出 的阳性数占83.3%,72h检出的阳性数占99%。假阳性率为0.87%。未发现假阴性。结论　应用ESP有较高 阳性检出率,缩短了培养时间,增加了检出细菌的种类,结果快速、准确。     

双相血培养瓶在诊断小儿败血症中的应用

我室采用法国生物-梅里埃公司生产的需氧双相血培养瓶( Hemo line),对1533例小儿发热待查病人进行了血液培养,结果239例阳性,阳性率15.6%,共分离35种菌株.现加以分析报道.     

全自动血培养系统检测730份需氧血培养结果分析

目的：评价全自动培养系统ＢａｃＴ／Ａｌｅｒｔ１２０的临床应用情况。方法：回顾性分析ＢａｘＴ／Ａｌｅｒｔ１２０全自动血培养系统检测７３０例需氧血培养的阳性率阳性检出时间,细菌种类以及阳性、假阴性率。结果;７３０例需 培养分离到８４株细菌,阳性率１１．５％,最快阳性检出时间２小时,２４小时内检出的阳性占６６．７％,４８小时内检出的阳性占８６．９％,７２小时内检出的阳性占９７．６％。８４株细菌分布于２８     

双相血培养瓶在诊断小儿败血症中的应用

我室采用法国生物 -梅里埃公司生产的需氧双相血培养瓶 ( Hemoline) ,对 1 533例小儿发热待查病人进行了血液培养 ,结果 2 39例阳性 ,阳性率 1 5.6% ,共分离 35种菌株。现加以分析报道。方　　法一、无菌操作取患儿血液 0 .5～ 2 ml注入双相血培养瓶 ,摇匀 ,培养 4h后 ,倾斜瓶子使培养物布满琼脂 ,然后垂直培养于 35℃至 1 6～ 2 4 h。观察液体及固体培养基上有无细菌生长。如无生长 ,再培养2 4 h,第二次观察结果。如仍阴性 ,再使培养物布满琼脂后孵育 ,每天观察至第 5天 ,每 48h倾斜瓶子转种一次。观察 5天无生长则报告阴性。二、如有细菌…     

新生儿微量血培养与常规血培养自身配对研究

新生儿败血症是新生儿期常见的感染性疾病。血培养仍不失为目前常用的特异性检测方法,为探讨采血量对结果的影响,我们于1995年1月～1997年12月对拟诊新生儿败血症的106例新生儿进行微量血培养与常规血培养自身配对研究(采血量分别为0.5ml及2ml)。现报道如下。     

新生儿败血症血培养及药敏结果分析

目的：了解新生儿败血症血培养细菌的分布及对抗生素敏感和耐药情况。方法：用药敏试条对新生儿败血症血培养出的细菌进行药敏试验。结果：普通血培养86份,检出细菌87株,其中表皮葡萄球菌占31.03％,溶血葡萄球菌占16.09%,金黄色葡萄球菌占14.94%,大肠埃希氏菌占10.34%.表皮葡萄球菌、大肠埃希氏菌对丁胺 那霉素与第三代头孢类中的先锋铋、头孢曲松钠均较敏感,上述菌株对青霉素面药率均较高。结论：细菌的耐药性呈上升趋势。丁胺卡那霉素与第三代头孢类中的先锋铋、头孢曲松钠为较有效的抗菌药物之一。     

儿童血培养细菌的分布及污染率分析

目的了解儿童血培养细菌的分布及污染率情况,为临床判断血培养细菌结果是否为污染提供可靠依据。方法对2011年1月1日-2012年12月31日共计6530份血培养的阳性细菌结果进行分析,根据临床资料、实验室数据和微生物学3个方面鉴别其中的污染细菌。结果6530份血培养共分离出细菌314株,阳性率为4．8％。其中G＋细菌228株,以凝固酶阴性葡萄球菌为主（占43．9％）,其次为金黄色葡萄球菌（占2．9％）,口细菌86株,以大肠埃希菌居多（占9．6％）,肺炎克雷伯菌次之（占8．3％）。其中污染细菌156株（占总检出的49．7％）,以凝固酶阴性葡萄球菌为主（占31．2％）,其次为芽孢杆菌属（占6．4％）。结论儿童血培养阳性污染率较高,污染以凝固酶阴性葡萄球菌为主,需综合临床和实验室的资料判定其临床意义,避免抗菌药物的不合理使用。     

Comparison of time to positivity of pediatric blood cultures obtained within the first year of life and in later years

The time to positivity (TTP) of blood culture has significant value for clinicians. However, almost all subjects of previous studies regarding TTP were adults and early infants. Therefore, careful attention is required when referring to previously published data, which might differ according to the age of subjects, as the tendency of infectious focus and pathogens identified from culture vary with age. In this study, we compared the TTP between two pediatric age groups (≤12 months and 13 months to 15 years [>12 months]) at a teaching hospital during a 5-year period. Of the 95 subjects, 41 and 54 were aged ≤12 and > 12 months, among whom true pathogenic bacteria were identified in 12 (29.3%) and 19 (35.2%), respectively. The median TTP for the younger group with pathogenic bacteria was 11.2 (interquartile range, 10.0–11.9) hours, which was significantly shorter than that for the older group (12.6 [interquartile range, 11.9–16.9] hours) (P = 0.01). At 12 h after the initiation of culture, the younger group with pathogenic bacteria had a significantly higher positivity rate (83.3%) than the older group (26.3%) (P < 0.01). The times required for the positivity to exceed 90% were 13.4 and 20.1 h for the younger and older pathogenic groups and 30.4 and 67.8 h for the younger and older contaminant groups, respectively. The range of TTP could be assessed more accurately by considering the effect of age on the infectious background.     

婴幼儿静脉采血部位及方法分析

目的：探讨婴幼儿血标本采集部位及方法。方法：对101例婴儿和168例幼儿,分别从手足背静脉、耳后静脉、股静脉、肘正中静脉、颈外静脉进行采血方法比较。结果：婴儿耳后静脉采血成功率83.7%,手足背静脉成功率是48.3%;幼儿股静脉采血成功率86.4%,肘正中静脉中成功率57.4%。差异均有显性（P＜0.005)。结论：提示不同年龄的小儿静脉采血部位有显区别。     

不同抗凝剂,温度,时间对血糖测定值的影响

用不同抗凝剂在不同温度及时间对血糖测定值的影响。结果提示,凡抗凝剂中加入氟化钠者,均可阻止血细胞对糖的酵解作用。一般1～9或1～12小时测定对血糖前后测定值影响不大(p>0.05),其后血糖值有下降(p<0.05)。在三种抗凝剂中,以抗凝剂Ⅰ(新抗凝剂)优于抗凝剂Ⅱ(草酸钾+NaF)与抗凝剂Ⅲ(肝素+NaF)。温度(2～4℃及15～18℃)对血糖测定值影响不大。     

血清降钙素原联合血培养连续检测对菌血症的诊断价值

目的探讨血清降钙素原(Procalcitonin,PCT)联合血培养连续检测对菌血症的诊断价值。方法对76例菌血症(菌血症组)、32例肿瘤热(肿瘤组)和20例健康体检(健康对照组)在首诊时检测血清PCT,并对菌血症组进行血培养,每隔24 h重复检测以上两指标,比较3组的血清PCT水平,分析连续检测对菌血症的诊断价值,并对菌血症组应用抗生素前后血清PCT检测结果进行分析。结果首次检测PCT,3组的阳性率分别为82.89%、15.62%、0%,菌血症组与肿瘤组、健康对照组比较差异均有统计学意义(P<0.01);菌血症组首次血培养阳性率22.36%,随着培养次数的增加,血培养阳性率增加;菌血症得到控制者的PCT水平呈下降趋势。结论血清PCT联合血培养连续检测不仅可提高菌血症的诊断率,还可用于菌血症治疗效果及预后的判断,临床医生可根据发热时间的长短,选择最佳的血培养时间,以提高菌血症的确诊率。     

Blood culture examinations at a community hospital without a microbiology laboratory: using an automated blood culture system and performing a Gram stain on positive culture bottles in the institution

To elucidate the existence of microorganisms from blood culture bottles in hospitals without a microbiology laboratory, we changed the system of blood culture examinations. The Oxoid signal blood culture system and submission of all blood cultures to the clinical testing industry was used from July 2002 to December 2002 (first period). Use of the BacT/Alert system and performing of Gram stain for positive culture bottles in our institutions was conducted from January 2003 to June 2003 (latter period). A total of 210 and 193 blood cultures were processed during the first and latter periods, respectively. There were 40 (19.0%) positive cultures in the first period and 32 (16.6%) positive cultures in the latter period. The times from the specimen collection to the Gram stain result that were required were 3.8 and 1.0 days in the first period and the latter period, respectively. The times required for the final report of the blood cultures in the first period and in the latter period were 5.8 and 4.9 days, respectively. We conclude that using a continuous monitoring, automated blood culture system and performing Gram stain for positive culture bottles in institutions without microbiology laboratories may be useful for medical doctors to rapidly determine the existence of microorganisms and to begin adequate antiinfective therapy.     

Evaluation of BACTEC Plus aerobic and anaerobic blood culture bottles and BacT/Alert FAN aerobic and anaerobic blood culture bottles for the detection of bacteremia in ICU patients

Blood culture is the most valuable laboratory test for the diagnosis of bacteremia and sepsis. The BACTEC FX and BacT/Alert 3D automated blood culture systems are commonly used in Korean health care facilities. A controlled clinical evaluation of the resin-containing BACTEC Plus aerobic (BA) and anaerobic (BN), and the charcoal-containing FAN aerobic (FA) and anaerobic (FN) bottles using blood from intensive care unit (ICU) patients was designed. The performances of these 2 systems with media containing particle absorbing antimicrobial agents were evaluated using the culture positivity rate and time to detection (TTD). TTD was collected using data management systems, either the Epicenter (BD Diagnostic Systems) or the hospital laboratory information system. A total of 1539 four-bottle sets were collected from 270 patients in medical and surgical ICUs. Blood culture samples included 1539 bottles each of BA, BN, FA, and FN, and yielded 113 (7.3%), 90 (5.8%), 104 (6.8%), and 80 (5.2%) positive bacterial or fungal isolates, respectively. There were significant differences between the resin-containing BA and BN samples in culture positivity and also between the charcoal-containing FA and FN samples, especially for Escherichia coli (25/27 versus 17/27, P < 0.05) and Acinetobacter baumannii (14/15 versus 7/15, P < 0.05). Significantly shorter recovery time was observed in BACTEC Plus aerobic bottles than in FAN aerobic bottles (17.2 and 24.7 h, respectively) (P < 0.001).     

Effects of an Individualized Fasting Program on Fasting Time and Comfort in Infants and Young Children During the Perioperative Period

PurposeThe study was designed to evaluate the effect of an individualized fasting program on fasting time and comfort in infants and young children during the perioperative period.DesignA quasiexperimental design was used.MethodsThe study included 675 children (intervention = 353, control = 322). Data collection tools included Characteristics of Children Form and the Infant Hunger Rating Scale. The fasting program included individualized fasting education and fasting in batches. On the day of the operation, clear liquids were fed 2 hours before surgery and refed after the patient woke after surgery.FindingsThe duration of perioperative fasting and the time to refeeding were shorter, the hunger scores were lower in the intervention group than those in the control group (P < .05). There was no difference in the incidence of vomiting between the two groups (P > .05), and no coughing and bloating occurred.ConclusionsThe fasting program for infants and young children can shorten the duration of fasting and can reduce the degree of hunger. This program is safe and feasible.