阳性报警时间预测成人血培养凝固酶阴性葡萄球菌临床意义的准确性评价  

Accuracy evaluation of time to positivity for predicting the clinical significance of coagulase negative Staphylococci in adult blood culture

作　　者：黄磊[1] 孙立颖[1] 严岩[1] 

机构地区：[1]北京大学第一医院检验科,100034

出　　处：《实用医学杂志》2013年第21期3594-3597,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81201338)

摘　　要：目的：评价阳性报警时间（rITrP）对预测成人血培养凝固酶阴性葡萄球茵（CoNS）临床意义的准确性。方法：对我院2008年至2012年血培养分离出CoNS的成年（〉16周岁）住院患者进行回顾性分析，并记录TTP根据临床资料和指南推荐的判断标准来判定CoNS是引起血流感染的病原茵还是污染，将患者分为血流感染组和污染组，比较两组1TrP的差异。用受试者工作曲线（ROC）分析TTP对预测CoNS临床意义的准确性。结果：收集到符合入选标准且临床资料完整的患者共130例，其中血流感染组81例，污染组49例。两组的TTP分别为（19．26±7．46）h和（30．72±13．48）h（P〈0．001）。ROC曲线表明TTP≤20．88h可作为区分血流感染与污染的最佳切点，曲线下面积为0．836（95％可信区间为0．761～0．895），灵敏度为72．8％．特异度为83．7％。结论：TTP对预测成人血培养CoNS临床意义的准确度为中等，具有可接受的敏感度和特异度．可作为一种辅助诊断指标。Objective To evaluate the accuracy of time to positivity （TTP） for predicting the clinical significance of coagulase negative Staphylococci （CONS） in adult blood culture. Methods 130 cases of of adult hospitalized patients （〉 16 years） between 2008 and 2012 with CoNS isolated from blood culture in our hospital were retrospectively analyzed, divided into bloodstream infection group （81cases）and contamination group （49 cases ）. Their TYP difference were compared. Receiver operator characteristic curve （ROC） was used to analyze TIP, evaluating that the CoNS was the microorganism of bloodstream infection or contamination. Results TIP of the two groups were （19.26 ± 7.46） h and （30.72 ± 13.48） h respectively （P 〈 0.001）. ROC curve showed that TFP ≤ 20.88 h was the optimal cut-off point to differentiate bloodstream infection and contamination, with the area under the curve （AUC） of 0.836 （95% Confidence Interval of 0.761 - 0.895）, sensitivity of 72.8% and specificity of 83.7%. Conclusion The accuracy of TIP for predicting the clinical significance of CoNS in adult blood culture is moderate, with acceptable sensitivity and specificity, can be used as an adjunct diagnosis parameter.

关 键 词：阳性报警时间 血培养 凝固酶阴性葡萄球菌 血流感染 

分 类 号：R446.5[医药卫生—诊断学]