延迟放瓶对2种自动化血培养系统苛养菌培养的影响

目的 比较延迟放瓶对2种自动化血培养系统苛养菌阳性检出率和检出时间的影响。方法 用肺炎链球菌和流感嗜血杆菌标准菌株制成不同浓度菌液模拟样本,分别接种到Bactec Peds Plus和BACT/ALERT PF培养瓶中,室温条件下放置0、8、16、24 h后,分别放入BACTEC FX血培养仪和BACT/ALERT 3D血培养仪,记录培养结果和报阳时间,并进行统计分析。结果 室温放置不同时间后,不同浓度菌液模拟样本在2种血培养仪中均可检测到阳性结果,BACTEC FX血培养仪报阳时间显著短于BACT/ALERT 3D血培养仪（P<0.001）。肺炎链球菌室温放置8、16和24 h后,报阳时间均显著长于放置0 h(P<0.05),且延迟放瓶时间与菌液浓度、血培养系统2个因素之间均存在交互作用（P<0.05）。流感嗜血杆菌延迟放瓶0和8 h的报阳时间差异无统计学意义（P>0.05）,且延迟放瓶时间与菌液浓度、血培养系统2个因素之间无交互作用（P>0.05）。结论 苛养菌模拟样本报阳时间随延迟放瓶时间的延长呈增加趋势,这一趋势受到菌种、菌液浓度、血培养系统等因素...     

3种不同全自动血培养仪的临床应用及评价

目的评估Bact/Alert 3D、BD BACTEC FX以及Versa TREK 3种不同全自动血培养仪之间的应用价值及其相互差异。方法比较3种仪器的培养结果的报阳时间及延迟培养的报阳时间,评价3种仪器的临床应用价值。结果 3种血培养仪在培养时间的比较上,BD的最短报阳时间的瓶数所占比例是29.4%,梅里埃的最短报阳时间的瓶数所占比例为11.8%,Versa TREK的最短时间报阳瓶数所占比例为58.8%。在延迟培养的比较中,3种仪器的时间差距较小,延迟培养条件下建议在常温下保存(4℃条件下苛养菌可能死亡)。结论Versa TREK在细菌的培养时间上有一定的优势,但其存在操作较为繁琐,污染率相对较高的风险,Bact/Alert 3D、BD BACTEC FX在培养时间上差距不是很大,且操作方便。     

A项BacT/ALERT 3D与B项BACTEC FX的血培养系统比对及性能评价

目的对两种血培养系统进行性能验证,探讨快速准确地做出病原学诊断的方法。方法两种血培养系统分成需氧瓶组、厌氧瓶组和儿童瓶组,将配置好的不同浓度梯度的标准菌悬液按要求分别注入血培养瓶内,按要求放入自动化仪器内进行培养,然后记录两个仪器每个瓶子的报阳时间,实验结束后对不同系统学培养瓶检出时间进行比较。结果在需氧瓶中,白色念珠菌、肺炎克雷伯菌、粪肠球菌和B群链球菌在细菌浓度为107、105及10 CFU/ml时,BACTEC FX检出时间早于Bac T/ALERT 3D;在厌氧瓶中,肺炎克雷伯菌、粪肠球菌和B群链球菌在细菌浓度为107、105及103CFU/ml时,BACTEC FX检出时间早于Bac T/ALERT 3D;在儿童瓶中,白色念珠菌、肺炎克雷伯菌、粪肠球菌和B群链球菌在细菌浓度为107、105、103及10 CFU/ml时,BACTEC FX检出时间均早于Bac T/ALERT 3D(P0.05)。结论两种血培养系统均能有效监测由细菌或者真菌引起的血液感染,BACTEC FX血培养瓶检出时间多数早于Bac T/ALERT 3D血培养瓶。     

BACTEC树脂需氧瓶与树脂厌氧瓶临床应用评价

目的评价BACTEC树脂需氧瓶和树脂厌氧瓶对血液中病原菌的检测能力。方法回顾性分析1241例BACTEC树脂需氧瓶、树脂厌氧瓶配对血液培养结果,比较分离病菌的种类及不同培养瓶报阳时间。结果 1 241份血液标本有138份报阳,分离病原菌141株(3份标本为复数菌感染)。需氧瓶和厌氧瓶分离病原菌126株和122株,107株病原菌可同时在两种血培养瓶生长,另有19株和15株分别只能在需氧瓶或厌氧瓶中生长。50%的肠杆菌和60%的阳性球菌的在厌氧瓶中生长迅速而先于需氧瓶报阳。结论厌氧树脂瓶检测菌血症有一定优势,联合使用需氧、厌氧瓶进行血培养能更有效、更快速诊断菌血症。     

两种全自动血培养系统的脐带血微生物检出率比较

目的 比较BACTEC FⅩ与BacT/ALERT 3D全自动血培养系统在脐带血微生物检出率的差异，比较不同培养时间、不同培养标本类型对脐带血微生物检出率的影响。方法 选取四川省脐带血造血干细胞库2020年4～8月制备的脐带血标本4 358例，培养标本为20 mL血浆；另选取2021年4～8月制备的脐带血标本4 057例，培养标本为19 mL血浆+1 mL终产品，合计8 415例。BACTEC FX检测标本4 849例(血浆组2 458例，血浆+终产品组2 391例);BacT/ALERT 3D检测标本3 566例(血浆组1 900例，血浆+终产品组1 666例),培养至5 d记录培养数据后继续培养至7 d,阳性结果须通过革兰染色确认。结果 培养阳性率比较，BACTEC FX阳性率4.08%高于BacT/ALERT 3D阳性率2.69%,差异有统计学意义(P<0.05);培养时间比较，BACTEC FX与BacT/ALERT 3D培养7 d阳性率较培养5d提高8%、4.26%;培养标本类型比较，采用BACTEC FX检测，血浆组与血浆+终产品组间阳性率差异有统计学意义(P<...     

BD BACTEC 9120全自动血培养仪阳性结果分析

目的评价BD BACTEC 9120全自动血培养仪阳性结果中的菌群类型和假阳性/假阴性情况。方法分析3100份临床标本中的病原菌种类和出现的假阳性/假阴性率及原因。结果BD BACTEC 9120全自动血培养仪假阳性率和假阴性率分别为6.35%和1.32%,假阳性中以白细胞增多和肿瘤患者为多。所有致假阴性菌种中,以真菌的比率最高;血培养病原菌以金黄色葡萄球菌和大肠埃希菌为多,分别为42.5%和25.5%。结论了解血培养菌群类型有助于指导临床用药,对BD BACTEC 9120血培养仪报道的阴性结果必须进行传代培养。     

需氧与厌氧配对培养在血流感染诊断中的价值

目的探讨需氧与厌氧配对培养在临床血流感染中的诊断价值。方法采用含树脂需氧瓶和含溶血素厌氧瓶配对培养,统计分析2012年7月至2014年6月送检的11 603份血培养中1 303份阳性菌株的分布和报阳时间。结果 1 303份血培养阳性标本中,厌氧瓶与需氧瓶均生长的有603株,仅需氧瓶生长的483株,仅厌氧瓶生长的217株。双瓶培养阳性率11.23%(1 303/11 603)与仅用单需氧瓶阳性率9.36%(1 086/11 603)或单厌氧瓶培养阳性率7.07%(820/11 603)比较,差异均有统计学意义(P0.01)。在厌氧瓶中还检出专性厌氧菌10例。双瓶均报阳的603株不同种属分离菌的厌氧瓶报阳时间均值早于需氧瓶。临床常见分离菌属两种培养瓶报阳时间比较具有统计学意义(P0.05)。结论需氧瓶与厌氧瓶配对培养在增加厌氧菌检出的同时,还能提高血培养的阳性率并缩短检出时长,为临床血流感染诊断和治疗提供依据,可指导临床合理使用抗菌药物。     

不同血培养瓶对细菌和真菌的培养检测分析

目的 :检测分析国产血培养瓶对细菌和真菌培养检测能力。方法 :将已知菌株的菌悬液稀释成不同浓度,定量加入3种不同的血培养瓶中,检测其细菌和真菌的生长情况。结果:国产血培养瓶的可检测浓度范围为1~108cfu/m L;国产血培养瓶报警时间比法国进口血培养瓶、美国进口血培养瓶均长,差异存在统计学意义(P值均为0.021)。结论 :国产血培养瓶基本可达到临床检测要求,对细菌和真菌的检出能力不亚于进口的血培养瓶,但缺点是报警时间比进口瓶长。     

两种血培养系统的需氧与厌氧瓶对模拟菌血症标本检测能力的对比研究

目的 对比BACTEC Plus需氧、厌氧血培养瓶和BacT/ALERT FA需氧瓶、FN厌氧瓶对模拟菌血症标本的检测能力.方法 采用健康献血者的5 ml无菌新鲜血液和定量菌液组成模拟菌血症标本202组,其中112组标本中加入定量抗菌药物以模拟患者接受抗菌药物治疗的情况.比较需氧瓶检测需氧菌、厌氧瓶检测专性厌氧菌和兼性厌氧菌,以及需氧瓶检测含有抗菌药物的需氧菌标本的平均检测时间(time-to-detect,TTD)和阳性率.结果 两种需氧瓶对需氧菌检测阳性率均为100%,对于102、103 CFU/ml两种浓度菌液,BACTEC Plus需氧瓶平均TTD分别为(13.69±3.74)h、(11.54±2.87)h,快于BacT/ALERT FA瓶平均TTD的(16.76±5.62)h、(14.47±4.30)h,两者比较差异有统计学意义(t=-5.674、-7.294,P＜0.01).对于专性厌氧菌,BACTEC Plus氧瓶和BacT/ALERT FN瓶阳性率分别为92%和100%,BacT/ALERT FN瓶的平均TTD分别为(22.60±9.16)h、(22.10±13.46)h,快于BACTEC Plus厌氧瓶平均TTD的(40.24±35.07)h、(34.88±17.34)h,两者比较差异有统计学意义(t=2.389、2.712,P＜0.05).对于兼性厌氧菌,BACTEC Plus厌氧瓶和BacT/ALERT FN瓶阳性率分别为100%和60%,BACTEC Plus厌氧的平均TTD为(13.24±7.82)h、(11.33±7.61)h,明显快于BacT/ALERT FN瓶平均TTD的(16.79±8.00)h、(19.27±14.71)h,两者比较差异有统计学意义(t=-3.440、-2.604,P＜0.05).对含有抗菌药物的需氧菌标本,BACTEC Plus需氧瓶和BacT/ALERT FA瓶阳性率分别为100%和57%,BACTEC Plus需氧瓶TTD多快于BacT/ALERT FA瓶.加人抗菌药物会延长TTD,且延长时间和两种培养的TTD时间差随抗菌药物浓度的增加而延长.结论 应根据患者的情况选择不同的血培养系统和培养瓶.对怀疑需氧菌或兼性厌氧菌感染,以及在进行血培养时已接受抗菌药物治疗的患者,选用BACTEC Plus需氧、厌氧血培养瓶;对怀疑厌氧菌感染的患者选用BacT/ALERT FN厌氧血培养瓶,能够更快地检出病原菌,并提高血培养阳性率.     

成人患者全自动血液培养病原菌分布及药敏分析

目的对成人血培养的病原菌分布、报阳时间及耐药性进行分析,以期为临床早期发现和治疗菌血症提供依据。方法收集2016年7月1日~12月31日陕西省人民医院送检的成人(年龄18周岁)血培养3 537套(需氧瓶+厌氧瓶/套)标本,对报阳瓶分离的病原菌菌株进行细菌鉴定和耐药性分析。结果 3 537套成人血培养标本,共检出485株病原菌,阳性率为13.7%。其中需氧瓶和厌氧瓶均报阳203套(占41.9%),仅需氧瓶报阳220瓶(占45.3%),仅厌氧瓶报阳62瓶(占12.8%)。其中革兰阴性菌229株,占47.2%,以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主,对亚胺培南均敏感。革兰阳性菌202株,占41.6%,以金黄色葡萄球菌、表皮葡萄球菌为主,对万古霉素均敏感。检出真菌54株,占11.1%。同时对203套需氧瓶和厌氧瓶均报阳的报阳时间进行分析:革兰阴性菌共121株,厌氧瓶报阳时间比需氧瓶报阳时间早的有95株,占78.5%。需氧瓶报阳时间比厌氧瓶报阳时间早的有26株,占21.5%。革兰阳性菌共78株,厌氧瓶报阳时间比需氧瓶报阳时间早的有45株,占57.7%。需氧瓶报阳时间比厌氧瓶报阳时间早的有33株,占42.3%。真菌共4株,各占50%。临床科室分布以重症医学科、急诊外科、呼吸内科为主。结论成人血培养分离出的病原菌以革兰阴性菌为主,病原菌的种类主要以人体的定植菌为主,且厌氧培养分离菌占比较高,不同病原菌的耐药性差异性大,建议临床医生应结合血培养及药敏结果针对性地对患者治疗。     

Bactec FX和Bact/Alert 3D两种血培养系统对菌血症的检出性能分析

目的对比分析Bactec FX血培养系统Bactec Plus树脂需氧瓶(简称BO-P瓶)和Bact/Alert 3D全自动血培养系统SA标准瓶(简称Bio-SA瓶)/SN厌氧瓶(简称Bio-SN瓶)对菌血症的检出能力及特点,探讨提高血培养阳性率、快速准确地作出病原学诊断的方法。方法从双侧部位抽取患者的静脉血,一侧注入BO-P瓶,另一侧注入Bio-SA瓶和Bio-SN瓶,置于相应培养系统培养,比较这3种血培养瓶的阳性率及检出时间。结果 6 188份标本中确认阳性765份(12.36%);确认污染134份(2.17%);假阳性11份(0.18%)。332株临床分离菌中BO-P瓶检出293例,占88.25%;Bio-SA瓶检出271例,占81.63%,前者阳性率高于后者(χ2=5.687,P<0.05);Bio-SN瓶检出201例,占60.54%,其中厌氧菌3例,占0.90%。与Bio-SA瓶相比,BO-P瓶检出阳性的时间优于Bio-SA瓶(P<0.05),尤其是对非发酵菌。污染菌以革兰阳性菌为主(89.55%),主要是凝固酶阴性的葡萄球菌(67.91%),少部分革兰阴性杆菌(9.7%)。结论双侧抽血并联合使用Bactec FX和Bact/Alert 3D血培养系统可利用各自优势,更有效地提高血培养阳性率。     

两种需氧血培养系统对模拟菌血症检测能力的比较

目的比较BACTEC PLUS树脂需氧瓶与BacT／Alert FA活性炭需氧瓶对模拟菌血症的检测能力。方法选择烧伤科常用的抗生素与细菌病原体，将菌液、抗生素、新鲜无菌血注入各培养瓶内，记录5d内阳性瓶的检出时间及二者对万古霉素的吸附能力，对2种具有不同吸附剂的血培养瓶的阳性检出率及平均检出时间进行比较。结果除替考拉宁组外，BACTEC PLUS树脂需氧瓶的细菌阳性检出率和平均检出时间均优于BacT／Alert FA活性炭需氧瓶，差异有统计学意义（P〈0．001）；替考拉宁组BacT／Alert FA活性炭需氧瓶的细菌阳性检出率和平均检出时间优于BACTEC PLUS树脂需氧瓶。结论在进行血培养时，应该尽可能在抗生素使用以前或F次使用抗生素以前采血。对已经应用抗生素的患者，应选择具有中和、吸附抗生素能力的培养系统。     

Clinical comparison of the BACTEC 9000 Standard Anaerobic/F and Lytic/F blood culture media

An 8-month prospective, volume controlled, comparison of Standard Anaerobic/F media with a new anaerobic high blood volume lytic medium (Lytic/F) was performed. A total of 2,092 compliant sets, consisting of an aerobic resin bottle or standard aerobic bottle, Standard Anaerobic/F, and Lytic/F bottle were evaluated. A total of 220 (10.6%) positive specimens were detected from the paired anaerobic bottles. These consisted of 194 true positive and 26 false positive bottles. Of 207 total organisms isolated, 122 were considered clinically significant. A comparison of significant organism recovery revealed 79 isolates in both anaerobic bottles, 7 isolates in the standard Anaerobic/F bottle only, and 36 isolates in the Lytic/F bottle only (p < 0.001). The Lytic/F bottle detected significantly more Enterobacteriaceae (p < 0.005) and Streptococci (p < 0.05). There were 24 false positive Standard Anaerobic/F bottles and 2 false positive Lytic/F bottles (p < 0.001). When both bottles were positive the Standard Anaerobic/F bottle was positive 12 hours earlier in 1 instance whereas the Lytic/F bottle was positive 12 hours earlier in 8 instances. The mean time for detection in the Standard Anaerobic/F bottle was 18.2 hours versus 13.2 hours for the Lytic/F bottle.The new Lytic/F anaerobic blood culture media was found to be superior to Standard Anaerobic/F media for both total organism recovery and time to organism detection.     

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).     

Clinical impact of extended blood culture examination: Too much of a good thing

Blood culture is the most critical examination for diagnosing bacterial infections. The longer the blood culture incubation period, the higher the chances of identifying bacterial strains. However, unnecessary extension of the incubation period can burden the capacity of the instrument and merely result in the detection of contaminant bacteria having no clinical significance. This study aimed to optimize the blood culture incubation period using the currently available continuous-monitoring automated blood culture instrument. This was a 2-year retrospective study performed at Osaka University Hospital (January 1, 2016 to December 31, 2017). The BD BACTEC™ FX blood culture system (Becton Dickinson, Sparks, MD, USA) and BD BACTEC™ Plus series blood culture bottles were used. All blood cultures were incubated for more than 12 consecutive days. We reviewed the clinical data of cases that tested positive between 6 and 12 days of incubation. During the study period, 14,822 sets of blood culture were drawn. Of 1751 sets testing positive, 95.7% (1665 sets) became positive within 5 days of incubation. The overall contamination rate (false positives) after 6 days of incubation was 80.2% (69/86 sets). Based on the positive blood culture results, antimicrobials were changed in 7.0% (6/86) of the sets, and a diagnosis of infectious disease was made in only one case. There was no death associated with the extended blood culture results. In conclusion, the clinical impact of extended blood culture incubation for 6 days or more was limited, and a routine extension of the incubation period might be unnecessary.     

全自动血培养瓶的再利用实验评价

目的评价全自动血培养瓶的再利用实验。方法研制高营养快速细菌培养液，并将其应用于全自动血培养仪进行再利用实验，分析阳性率、阳性检出时间和检出菌的种类。结果经59例全自动血培养再利用实验，平均检出时间在再利用血培养瓶与仪器对照组之间无显著的差异（P〉0．05）。608例再利用血培养分离到78株细菌，阳性率12．9％，24h内检出的阳性占64．1％，48h内检出的阳性占87．2％。72h内检出的阳性占96．2％。结论临床应用全自动血培养瓶的再利用实验可提高血培养阳性率。缩短检测时间，减少污染机会。结果快速准确。     

BD BACTEC™ Mycosis IC/F culture vials for fungemia diagnosis and follow-up: a retrospective study from 2013 to 2020

This retrospective study compared the BD BACTEC? Mycosis IC/F with the BD BACTEC? Plus Aerobic/F and BD BACTEC? Lytic Anaerobic/F culture vials (i.e., standard vials) for fungemia diagnosis at Nîmes University Hospital, France. From 2013 to 2020, 57 blood samples were concomitantly collected in the 3 culture vial types. For 43.8% of these samples, all vials were positive for yeast. The mean time to positivity was shorter (32.0 hours vs 44.2 hours; ?12.2 hours) and longer (89.4 hours vs 33.7 hours; +55.7 hours) with the BD BACTEC? Mycosis IC/F culture vials than with the other culture vials in patients without and with antifungal treatment, respectively. Moreover 31.6% and 24.6% of samples were positive only with the standard vials and with the BD BACTEC? Mycosis IC/F culture vials, respectively. The BD BACTEC? Mycosis IC/F culture vials are useful for the initial fungemia diagnosis (before any treatment) because they provide faster results.     

全自动血培养瓶的再利用实验评价

目的 评价全自动血培养瓶的再利用实验。方法 研制高营养快速细菌培养基,并将其应用于全自动血培养仪进行再利用实验,分析阳性率、阳性检出时间和检出菌的种类。结果 经32例全自动血培养再利用实验,平均阳性检出时间在再利用血培养瓶与仪器对照组之间无显著的差异(P<0.05)。608例再利用血培养分离到78株细菌,阳性率12.9％,24 h内检出的阳性占64.1％,48 h内检出的阳性占87.2％,72h内检出的阳性占96.2％。结论 临床应用全自动血培养瓶的再利用实验可提高血培养阳性率,缩短检测时间,减少污染机会,结果快速、准确。     

Comparison of two commercial broth-culture systems for microbial detection in dialysates of patients on continuous ambulatory peritoneal dialysis

The capability of two commercial systems was studied for microbial detection in dialysis effluents from patients on continuous ambulatory peritoneal dialysis (CAPD). Two methods of processing dialysate from patients on CAPD were compared: (a) direct inoculation of 10 ml of dialysate into a single bottle broth culture system (Signal; Oxoid, U.S.A., Columbia, Maryland) and 5 ml into each of two BACTEC blood culture bottles (Johnston Laboratories, Towson, Maryland); and (b) centrifugation of 50 ml of dialysate and culture of the sediment in an Oxoid bottle. Of the 196 specimens cultured, 99 (51%) yielded growth. Recovery rates of significant isolates were 95% for the BACTEC system, 89% for the Oxoid system, and 88% for the centrifugation-Oxoid system. Recovery of eight isolates from the Oxoid system was by subculture rather than a visual "signal." The Oxoid system is a practical, cost-effective, alternative culture method for effluents from CAPD patients in laboratories not having access to the BACTEC system.