双侧双瓶血培养在临床应用的初步研究

目的探讨双侧双瓶血培养在临床应用的必要性。方法采用全自动血培养仪对2010年4月～2011年4月南京医科大学第一附属医院血液科送检的693份血液标本进行培养,对双侧双瓶、单侧双瓶和单侧单瓶血培养的真阳性率和污染率分别进行统计学分析。结果 308份双侧双瓶标本中,有44份培养出细菌,其中37份为有意义阳性标本,真阳性率为12.0%(37/308),污染率为2.3%(7/308);320份单侧双瓶标本中,阳性标本31份,有意义的阳性标本23份,真阳性率为7.2%(23/320),污染率为2.5%(8/320);65份单侧单瓶标本中,有7份细菌生长,其中4份为凝固酶阴性葡萄球菌生长,真阳性率为4.6%(3/65),污染率为6.2%(4/65)。双侧双瓶血培养真阳性率明显高于单侧双瓶(χ2=4.051,P<0.05)及单侧单瓶,但与后者比较无统计学意义。3种培养方法污染率比较差异无统计学意义(P>0.05)。结论双侧双瓶血培养可提高血培养阳性率,且并不增加污染率。推广双侧双瓶血培养在临床应用有一定价值。

Clinical application of bilateral double bottles in blood culture

Objective To evaluate the value of bilateral double bottles for blood culture in clinical application.Methods A total of 693 blood samples obtained from the department of hematology of the First Affiliated Hospital of Nanjing Medical University from April 2010 to April 2011 were detected by automated blood culture system.The true-positive rate and the pollution rate were analyzed with 3 blood culture model,i.e.,bilateral double bottles,unilateral double bottles and unilateral single bottle.Results In 308 samples of bilateral double bottles blood culture,bacterium grew in 44 samples.The number of significant positive samples was 37,and the true-positive rate was 12.0%(37/308),and the pollution rate was 2.3%(7/308).In 320 samples of unilateral double bottles blood culture,bacterium grew in 31 samples.The number of significant positive samples was 23,the true-positive rate was 7.2%(23/320),and the pollution rate was 2.5%(8/320).In 65 samples of unilateral single bottle blood culture,bacterium grew in 7 samples,in which 4 samples grew coagulase negative staphylococcus in single bottle,the true-positive rate was 4.6%(3/65),and the pollution rate was 6.2%(4/65).The true-positive rate of bilateral double bottles blood culture was higher than that of unilateral double bottles blood culture(χ2=4.051,P<0.05),and it was also higher than that of unilateral single bottle blood culture,but there was no significant difference.No significant difference of the pollution rates was found among the three culture methods.Conclusion Bilateral double bottles blood culture method may increase the true-positive rate of blood culture and did not increase the pollution rate.The bilateral double bottles blood culture showed available value for clinical application.