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。

Comparison of ability and characteristics of Bactec FX and Bact/Alert 3D blood culture systems in detection of bacteremia

Objective To compare the capabilities and characteristics of Bactec FX resin blood culture system Bactec Plus aerobic bottles(referred to as BO-P bottle) and the Bact/Alert 3D automated blood culture system SA standard bottles(referred to as Bio-SA bottle)/SN anaerobic bottle(referred to as Bio-SN bottle) in the detection of bacteremia and study the practical methods for improving the positive rate of blood culture and etiology diagnosis.Methods The venous blood were taken from different parts of each patient,then was injected to BO-P bottle,Bio-SA and Bio-SN bottles respectively,and were cultured by the corresponding culture systems.The results of positive rate and detection time of the three blood culture bottles were compared.Results The meaningful 765 specimens was positive(12.36%) in 6188 specimens,and 134 were confirmed as polluted,accounting for 2.17%.Eleven specimens was false positive,accounting for 0.18%.By using BO-P bottle 293 cases in 332 clinical isolates were detectable,accounting for 88.25%,by using Bio-SA bottles 271 cases were detectable,accounting for 81.63%,by using Bio-SN bottles 201 cases were detectable,accounting for 60.54%,including 3 cases of anaerobic bacteria,accounting for 0.9%.The positive rate(P<0.05) and detection time(P<0.05) of BO-P bottle were significantly better than Bio-SA bottle,especially for non-fermented bacteria.Gram-positive bacteria(89.55%) was the main bacterial contamination,especially coagulase-negative staphylococci(67.91%),but there were also gram-negative bacteria(9.7%).Conclusion The blood specimen should be collected from bilateral arms.The advantages of Bactec FX blood culture system and Bact/Alert 3D automated blood culture systems should be combined and performed simultaneously.In this way the diagnosis of bloodstream infections may be effectively improved.