提高腹膜透析相关感染性腹膜炎致病菌培养阳性率的方法学研究  

Improved culture methods of effluent in peritoneal dialysis-related infectious peritonitis

作　　者：冯敏[1] 郭群英[1] 余学清[1] 陈冬梅[2] 阳晓[1] 姜宗培[1] 毛海萍[1] 陈崴[1] 董秀清[1] 傅君舟[3] 李剑文[3] 陈林[3] 

机构地区：[1]中山大学附属第一医院肾内科,广州510080 [2]中山大学附属第一医院检验科,广州510080 [3]广州市第一人民医院肾内科

出　　处：《中华肾脏病杂志》2007年第6期345-350,共6页Chinese Journal of Nephrology

基　　金：高等学校全国优秀博士学位论文作者专项资金（2003061）;霍英东基金会高等院校青年教师基金（101044）;广东省科技计划项目（2004B30701001）

摘　　要：目的探讨改进腹膜透析相关感染性腹膜炎透出液致病菌的培养方法,提高病原菌的培养阳性率。方法收集27例患者45例次腹膜炎透出液标本。腹膜炎患者透出液同时按以下6组方法分别进行致病菌培养：传统平板法、离心平板法、BacT/Alert培养瓶法（PF瓶法、SA瓶法、SN瓶法）和冻融法。结果离心平板组阳性率高于传统平板组,差异具统计学意义（60．0％比44．4％,P＜0．05）;与离心平板组相比,PF瓶组（84．4％）、SA瓶组（82．2％）和SN瓶组（82．2％）阳性率均提高（P均＜0．01）。在检测致病菌生长所需时间（TDG）方面,与离心平板组[（24．31±9．80）h]相比,PF瓶组[（14．25±9．13）h]、SA瓶组[（12．75±7．47） h]和SN瓶组[（9．79±4．14）h]的TDG均缩短（P均＜0．01）;SN瓶组的TDG比PF瓶组和SA瓶组更显著缩短（P均＜0．01）。结论离心法能显著提高培养阳性率。BacT/Alert培养系统与普通平板技术相比,能显著提高培养阳性率并缩短检测致病菌生长所需时间。SN培养瓶法检测致病菌生长所需时间最短。Objective To compare improved culture methods of pathogenic organism in peritoneal effluent with conventional methods, in order to decrease the culture-negative rate of pathogenic organism in patients with peritoneal dialysis（PD）-related infectious peritonitis. Methods Effluents of 45 peritonitis episodes from 27 patients were included. Effluents were cultured with different methods dividing into the following 6 culture groups： conventional plate group （P group）, centrifugation plate group （CP group）, BacT/Alert culture bottle groups （PF group, SA group and SN group） and frozen-lysis group （FL group）. Results The culture-positive rate of CP group was significantly higher than that of P group （60.0% vs 44.4%, P〈0.05）. Compared with CP group, the culture-positive rates of PF group （84.4%）, SA group （82.2%） and SN group （82.2%） were significantly increased （all P〈0.01）. Concerning the time to detect growth （TDG）, compared with that of CP group [（24.31±9.80） h], those of PF group [（14.25±9.13） h], SA group [（12.75±7.47） h] and SN group [（9.79±4.14） h] were significantly shortened （all P〈0.01）. SN group had the shortest TDG compared with PF group and SA group （all P〈0.01）. Conclusions Centrifugation of effluent is proved to increase the culture-positive rate of pathogenic organism in patients with PD-related infectious peritonitis. Culturing the effluent with BacT/Alert system is superior to plate technique in the aspects of increased culture-positive rate and fastened speed to detect the microbiological growth. Culturing with SN bottle is the fastest method to detect microbiological growth in PD-related infectious peritonitis compared with PF bottle and SA bottle.

关 键 词：腹膜透析 腹膜炎 致病菌 培养方法 

分 类 号：R686[医药卫生—骨科学]