两种吸附抗生素血培养瓶对血流感染检测能力的比较

目的：比较具有吸附抗生素能力的2种血培养瓶,即BACTEC PLUS树脂需氧瓶（简称BD-P瓶）与BacT/Alert FA活性炭需氧瓶（简称Bio-FA瓶）对血流感染的检测能力。方法每位患者从两个不同部位采集血标本分别注入BD-P瓶和Bio-FA瓶,放入相应培养仪进行培养,记录报阳时间。结合临床用药资料对这2种具有不同吸附剂的血培养瓶的阳性检出率及报阳时间进行比较。结果在6670瓶血培养中阳性报警共1017瓶,确认污染196瓶（2．94％）,有临床意义的阳性821瓶（12．31％）。共检出病原菌493株,其中双瓶阳性334例（67．75％）;BD-P瓶单瓶阳性102例（20．69％）,Bio-FA瓶单瓶阳性57例（11．56％）。 BD-P瓶对病原菌的检出率优于Bio-FA瓶（P＜0．01）,对于肠杆菌科和葡萄球菌的检出率BD-P瓶明显高于Bio-FA瓶（P＜0．01）。 BD-P瓶细菌报阳时间早于Bio-FA瓶（P＜0．01）,特别是对肠杆菌科和非发酵菌的阳性报警时间明显早于Bio-FA瓶。由正在使用药物治疗的患者中检出344例阳性,其BD-P瓶的阳性检出率和报阳时间均高于和快于Bio-FA瓶（P＜0．05）;按不同的治疗药物进行分组,对头孢哌酮/舒巴坦BD-P瓶的吸附能力更强（P＜0．05）。结论应用BD-P瓶检测血流感染较Bio-FA瓶检出率更高,检测速度更快。而联合使用Bio-FA瓶和BD-P瓶,比单用一种培养瓶更具优势。     

结核分支杆菌临床分离株耐药性调查

目的 调查北京胸科医院1992—1998年1943例结核分支杆茵临床分离株对硫酸链霉素(SM)利福平(RFP)乙胺丁醇(EB)异烟肼(INH)的耐药情况。方法 BACTEC460检测系统快速培养法。结果 RFP耐药率为24.5％;SM21.7％;INH19.6％;EB3.4％,总耐药34.3％(耐一种以上者);多耐12.2％(耐RFP及INH两种以上者)。SM、RFP、EB、INH、总耐药及多耐耐药率98年均低于92年。结论 98年结核分支杆菌临床分离株耐药率低于92年,总体来说耐药率呈下降趋势。     

延迟放瓶对两种血培养系统BacT/AlERT3D与BACTEC 9120阳性检出率的影响

目的 比较延迟放瓶对两种血培养系统BacT/AlERT 3D与BACTEC 9120阳性检出率的影响.方法 将4种常见临床菌种制成不同浓度菌液分别接种到BacT/AlERT FA与Bactec Plus(Aerobic)培养瓶中,将培养瓶分为立即放入BacT/AlERT 3D和BACTEC 9120培养仪中和分别在室温(22℃)和35℃孵育条件下延迟8、16、24 h后放入上述培养仪中等各组,记录报阳时间和计算阳性检出率.结果 无论是室温(22℃)还是35℃孵育,BacT/AlERT 3D中的培养瓶在分别延迟0、8、16、24 h放入时.阳性检出率差异无统汁学意义;而BACTEC 9120中的培养瓶分别延迟0、8、16 h时其阳性榆出率差异无统计学意义;而延时24 h放瓶时其阳性检出率则显著下降;BacT/AlERT 3D和BACTEC 9120在延时放瓶0、8、16 h时两者的阳性检出率差异均无统计学意义;而延迟24 h放瓶时前者的阳性检出率明显高于后者;两种血培养仪在22℃孵育的阳性检出率和35℃孵育时的检出率差异无统计学意义.结论 临床上血培养瓶应尽可能早的放人培养仪,BacT/AlERT 3D的延迟放瓶时间应在24 h以内,BACTEC 9120则应在16 h以内,延时孵育温度应为室温.     

Actinomyces in the vaginas of women with and without intrauterine contraceptive devices

Either Actinomyces israelii, A. naeslundii, or Arachnia propionica was found, by immunofluorescence studies, in cervicovaginal mucus from 36% of 50 women. One or more of these organisms were found in a surprising 27% of those with neither intrauterine contraceptive devices (IUDs) nor intravaginal foreign bodies. The only common finding was abundant vaginal mucus, and no clinical features were more serious than vaginal itching, odor, or vague discomfort. Among those women who harbored actinomycetes, the average duration of continuous IUD use was 5.3 years; the comparable figure for those with no infection was 2.1 years.     

Ultrastructural investigations of peripheral nerves in neuronal ceroid-lipofuscinoses (NCL)

Summary Specimens of brachial plexus, sural nerve and two cranial nerves of one patient with the Jansky-Bielschowsky type and 3 patients with the Spielmeyer-Sjögren type of NCL were studied by electron microscopy. Significant light microscopic changes were absent in all specimens. Ultrastructurally, curvilinear and/or fingerprint inclusions were present in each case, located chiefly in Schwann cells. These diagnostic findings were, however, overshadowed by masses of lamellar -granule-like cytosomes, usually not mixed with curvilinear or finger-print profiles in the juvenile cases and only rarely associated with curvilinear profiles in the late infantile case. Since secondary changes of axons and myelin sheaths were mild, these lamellar cytosomes might indicate chronic damage to Schwann cells, perhaps by wear and tear as seen in aging as well as NCL. On account of the abundance of -granules in NCL, peripheral nerve biopsy appears less suitable for confirming this diagnosis than biopsy of skin, striated muscle and rectal tissue.These investigations were supported by USPHS grant NS-04607 and by grants from the Children's Brain Diseases Foundation, San Francisco, U.S.A., and the Deutsche Forschungsgemeinschaft, SFB 33.     

Multicenter Research on the BACTEC MGIT 960 system for the second-line drugs susceptibility testing of Mycobacterium tuberculosis in China

The reliability of the BACTEC MGIT 960 system for the second-line drugs (capreomycin [CPM], kanamycin [KAN], ofloxacin [OFX] and ethionamide [ETH]) susceptibility testing (DST) of Mycobacterium tuberculosis (M. tuberculosis) was compared to that of traditional Lowenstein-Jensen (L-J) proportion method (PM) among four different sites in China. After resolution of discrepant results by retesting the strains using both methods in the National Reference Laboratory of tuberculosis, the overall concordance values between the 2 systems were 99.7% (kappa value: 0.97) for CPM, 99.7% (kappa value: 0.97) for KAN, 100.0% (kappa value: 1.00) for OFX, and 98.6% (kappa value: 0.95) for ETH. The average turnaround time with BACTEC MGIT 960 system among four sites was 8.9 ± 1.7 days, significantly shorter than 28 days with the traditional L-J PM. Therefore, the BACTEC MGIT 960 system is a reliable and rapid method for the second-line drug susceptibility testing of tuberculosis in China. Notably, a stricter quality control program should be routinely carried out when clinical laboratories perform the second-line DST with BACTEC MGIT 960 system.     

Use of bactec 460 TB system in the diagnosis of tuberculosis

PurposeTo evaluate, the efficacy of BACTEC 460 TB system for the diagnosis of tuberculosis in a tertiary care hospital in Mumbai, India. Methods: We compared 12,726 clinical specimens using BACTEC 460 TB system and conventional method for detection of Mycobacterium tuberculosis over a period of six years. Result: The overall recovery rate was 39% by BACTEC technique and 29% using Lowenstein-Jensen (LJ) medium. An average detection time for BACTEC 460 TB system was found to be 13.3 days and 15.3 days as against 31.2 days and 35.3 days by LJ method for respiratory and nonrespiratory specimens respectively. The average reporting time for drug susceptibility results ranged from 6-10 days for the BACTEC 460 TB system. Conclusions: The BACTEC system is a good system for level II laboratories, especially in the diagnosis of extrapulmonary and smear negative tuberculosis.     

A comparative study for the detection of Mycobacteria by BACTEC MGIT 960, Lowenstein Jensen media and direct AFB smear examination

PURPOSE: To compare BACTEC MGIT 960 (M960) with conventional culture on Lowenstein Jensen (LJ) media and direct acid fast bacilli (AFB) smear examination for the detection of Mycobacteria in clinical samples obtained from suspected cases of pulmonary and extra pulmonary tuberculosis (TB). METHODS: A total of 500 samples were processed for direct AFB smear examination, and culture on M960 and LJ media. RESULTS: Two hundred fifty-eight out of 500 (51.6%) isolates of Mycobacteria were obtained by combined use of the two culture methods. Two hundred and fifty-three (50.6%) were positive in culture by M960 and LJ media and 28% (140/500) by direct AFB smear examination. The positivity rate of M960 system alone was 34.10% (88/258) and of LJ alone was 1.93% (5/258). Average time to detect growth (TTD) was 9.66 days by M960 and 28.81 days by LJ. CONCLUSIONS: M960 system is a rapid and sensitive method for early diagnosis of pulmonary and extrapulmonary TB. But for maximum recovery of Mycobacteria , a combination of both M960 and LJ media should be used.