血培养阳性标本直接药敏试验临床应用价值的评估  

Clinical application value of positive blood culture specimens for direct drug susceptibility testing

作　　者：王书侠[1] 张家明[1] 周竞[1] 姚孝明[1] 曹萌[2] 麻全慧[1] 

机构地区：[1]江苏省中医药研究院检验科,江苏南京210028 [2]江苏省中医药研究院内分泌学研究室,江苏南京210028

出　　处：《中华医院感染学杂志》2016年第10期2270-2272,共3页Chinese Journal of Nosocomiology

基　　金：江苏省自然科学基金资助项目(BK20131037)

摘　　要：目的研究血培养阳性标本直接药敏结果的可靠性和方法的可行性,为临床血流感染的快速治疗提供指导。方法选取医院2014年1-3月的64份血培养阳性标本,其中革兰阳性菌33份,革兰阴性菌31份,取培养液直接涂片革兰染色,观察细菌形态及染色;用培养液原液分别直接涂布和离心后的上清液涂布M-H平板,根椐染色结果选用不同药敏纸片作纸片扩散法(K-B法)药敏试验,同时按常规操作接种平板分离菌株后作标准药敏试验,分别比较直接药敏及上清药敏与标准药敏结果的符合程度和两种方法之间的差异。结果测试的64份标本,直接药敏及上清药敏与标准药敏结果相比,结果的误差率均在可接受范围内,与标准药敏结果相比,原液直接药敏与离心后上清药敏结果的符合率之间差异均无统计学意义。结论血培养直接药敏与标准药敏结果有很好的符合率,培养液是否离心对结果影响差异无统计学意义,直接药敏缩短了检验时间,减少了抗菌药物的滥用。OBJECTIVE To explore the reliability and feasibility of positive blood culture specimens for direct drug susceptibility testing so as to provide guidance for rapid clinical treatment of bloodstream infections.METHODS From Jan 2014 to Mar 2014,totally 64 positive blood culture specimens were collected,including 33 specimens cultured positive for gram-positive bacteria and 31 specimens cultured positive for gram-negative bacteria.The culture media were treated with direct smear and gram staining,the morphological characteristics of bacteria and dyeing were observed.The original fluid of culture media was directly coated,the centrifuged supernatant was coated on M-H plate,the drug susceptibility testing was carried out by using disc diffusion method（K-B method）based on the staining results,meanwhile,the standard drug susceptibility testing was conducted for the strains isolated from the plate by using the conventional operation.The coincidence rate was compared between the result of direct drug susceptibility testing and the result of standard drug susceptibility testing and between the result of supernatant drug susceptibility testing and the result of standard drug susceptibility testing,and the differences between the two methods were observed.RESULTS The error rate between the result of direct drug susceptibility testing and the result of standard drug susceptibility testing and the error rate between the result of supernatant drug susceptibility testing and the result of standard drug susceptibility testing were acceptable for the 64 tested specimens;as compared with the result of standard drug susceptibility testing,there was no significant difference in the coincidence rate between the result of original fluid direct drug susceptibility testing and the result of centrifuged supernatant drug susceptibility testing.CONCLUSION The coincidence rate is high between the result of blood culture direct drug susceptibility testing and the result of standard drug susceptibility testing,and the centrifuged culture m

关 键 词：血流感染 血培养 直接药敏 评估 

分 类 号：R446.5[医药卫生—诊断学]